
I! 



BIDDLE'S 



MATERIA MEDICA 



AND 



THERAPEUTICS. 



A New Series of Manuals 

FOR 

Medical Students. 

Price of each Book, Cloth, $3.00; Leather, $3.50. 

MIDWIFERY. By Alfred Lewis Galabin, m. a., m.d., Obstetric 
Physician to, and Lecturer on Midwifery and the Diseases of Women at, 
Guy's Hospital, London, etc 227 fine Engravings. 753 pages. 

PHYSIOLOGY. Third Edition. By Gerald F. Yeo, m.d., f.r.c.s., 
Professor of Physiology in King's College, London. Revised. 743 
pages. 321 carefully printed Illustrations. 

MATERIA MEDICA, PHARMACY AND THERAPEUTICS, 
including the Physiological Action of Drugs, Special Therapeutics, 
Official and Extemporaneous Pharmac y, with numerous Tables, Form- 
ulae, Notes on Temperature, Clinical Thermometer, Poisons, Urinary 
Examinations and Patent Medicines. By Saml. O. L. Potter, m. a., 
m.d., Professor of Practice of Medicine, Cooper College, San Francisco; 
Late Surgeon U. S. Army. 750 pages. 

CHILDREN. By J. F. Goodh art, m.d., Physician to the Evelina 
Hospital for Children ; Assistant Physician, Guy's Hospital, London. 
American Edition. Revised and Edited by Louis Starr, m.d., Clinical 
Professor of Diseases of Children in the Hospital of the University of 
Pennsylvania; Physician to the Children's Hospital, Philadelphia. 50 
Formulae, and directions for pre paring Artificial Human Milk, for the 
Artificial Digestion of Milk, etc. 738 pages. 

PRACTICAL THER APEUT ICS. Fourth Edition. With an Index 
of Diseases. By Ed. John Waring, m.d., f.r.c.p. Rewritten and 
Revised. Edited by Dudley W. Buxton, Assistant to the Professor of 
Medicine, University College Hospital, London. 744 pages. 

MEDICAL JURISPRUDENCE AND TOXICOLOGY. By John 
J. Reese, m.d., Professor of Medical Jurisprudence and Toxicology, 
University of Pennsylvania, etc. 606 pages. Second Edition. 

ORGANIC CHEMISTRY. By Prof. Victor von Richter, Univer- 
sity of Breslau. Translated from Fourth German Edition by Edgar F. 
Smith, m.a., ph.d., Professor of Chemistry, Wittenberg College, Spring- 
field, O., formerly in the Laboratories of the University of Pennsylvania, 
etc. Illustrated. 710 pages. 

WINCKEL'S DISEASES OF WOMEN. By Parvin. A new 
Text-Book. By Dr. F. Winckel, Professor of Gynaecology, etc., Royal 
University of Munich. The Translation Edited by Theopiiilus Parvin, 
m.d., Professor of Obstetrics and Diseases of Women and Children, Jef- 
ferson Medical College, Philadelphia. 132 Engravings, most of which 
are new. 700 pages. 

PRACTICAL SURGERY. A Manual for Students and Physicians. 

By Wm, J. Walsham, m.d., Assistant Surgeon to, and Demonstrator of 
• Surgery in, St. Bartholomew's Hospital; Surgeon to Metropolitan Free 

Hospital, London, etc. Thoroughly Illustrated. About 700 pages. 

*** Other Volumes in Preparation. A complete illustrated circular with 
sample pages sent free, upon application. 

Price of each Book, Cloth, $3,00; Leather, $3.50. 
P. BLAKISTON, SON & CO., Medical Publishers & Booksellers, 

1012 Waln£rr. Street, Philadelphia. 



MATERIA MEDICA 



THERAPEUTICS, 



FOR PHYSICIANS AND STUDENTS. 

f BY 

JOHN B. BIDDLE, M.D., 

LATE PROFESSOR OF MATERIA MEDICA AND GENERAL THERAPEUTICS IN THE JEFFERSON MEDICAL 
COLLEGE. PHILADELPHIA. 



ELEVENTH EDITION, 

REVISED AND ENLARGED, 

WITH SPECIAL REFERENCE TO THERAPEUTICS AND TO THE 
PHYSIOLOGICAL ACTION OF MEDICINES. 



BY 

CLEMENT BIDDLE, M. D., U. S. Navy, 

AND 

HENRY MORRIS, M. D, 

FELLOW OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA; DEMONSTRATOR OF OBSTETRICS 
AND GYNECOLOGY IN JEFFERSON MEDICAL COLLEGE, ETC., ETC. 

^VOFCO/V^ 

( *P; 6 1889^1 

WITH v r / A 

NUMEROUS ILLUSTRATIONS. 



PHILADELPHIA : 

P. BLAKISTON, SON & CO., 

No. 1012 Walnut Street. 




Entered, according to Act of Congress, in the year 1889, 

By P. BLAKISTON, SON & CO., 
In the Office of the Librarian of Congress, at Washington. 



Press of Wm F. Fell &. Co., 
1220-24 Sansom St., 

PHILADELPHIA. 



PREFACE 



TO THE ELEVENTH EDITION. 



The exhaustion of the tenth edition of Biddle's Materia 
Medica has rendered necessary the preparation of a new one. 
In doing this the editors have carefully gone over the entire 
work, paying particular attention to the expurging of obsolete 
matter, the correction of errors, and the re-writing of various 
articles that it seemed to need. 

They desire to call attention to the following subjects as con- 
stituting the principal alterations made by them, viz. : The addi- 
tion of twenty-one new cuts, the omission of useless ones, the 
introduction of concise statements of the action of new drugs 
that have recently crept into the domain of pharmacology, as 
Hypnone, Urethan, Papaya, Adonidine, Strophantus, Sparteine, 
Iodol, Morrhuol, Lanolin, and Saccharin. An entirely new 
chapter has been added on Antipyretics, in which the phenyl- 
derivatives, as Acetanilide (anti-febrine), Resorcin, Hydroquinone, 
Pyrocatechin, Salol, Naphthaline and Naphthol, Pyridine, 
Chinoline, Kairine, Thalline, and Antipyrine have been tho- 
roughly considered. New articles on Mercuric Chloride and 
Iodide as antiseptic agents have also been introduced, and the 
article on Electricity re-written and enlarged. Numerous articles 
have been much extended, particularly quinine, opium, bella- 
donna, aconite, digitalis, etc., the medicinal uses of which have 
been more dwelt upon than in former editions. 

Useless botanical descriptions (notably in Rhubarb, Aloes, 
and Acacia) have been curtailed, while the therapeutical applica- 



VI PREFACE. 

tion of the majority of drugs has been elaborated. To increase 
the usefulness of the index, which is as full as that of previous 
editions, bolder type has been used in referring to the principal 
actions and uses of the various drugs. The editors wish to 
acknowledge their indebtedness to Dr. T. D. Reed, of Montreal, 
and Prof. F. B. Power, of the University of Wisconsin, for 
numerous valuable suggestions and corrections, as well as to the 
numerous kindly criticisms on the last edition. 

In conclusion, it affords them much pleasure to renew the 
dedication of the author to the gentlemen in attendance upon 
the various medical schools in North America. 

Clement Biddle. 

Henry Morris. 

Philadelphia, April I, 1889. 



PREFACE 

TO THE EIGHTH EDITION 



The exhaustion of the seventh edition of the Materia Medica 
within little more than a year since it was issued, having ren- 
dered necessary the publication of a new edition, it has been 
carefully revised, much of it has been recast and even rewritten, 
and many new articles have been added. The author trusts 
that it will be found to have kept pace with the progress of 
pharmacological science, and to contain all important recent 
contributions to the various departments of pharmacology. 

The illustrations of the book comprise, as in previous editions, 
representations of most of the important indigenous and natu- 
ralized plants, as well as diagrams of instruments employed in 
the atomization of liquids, in the new operation of pneumatic 
aspiration, in the transfusion of blood, and in the recently-intro- 
duced pneumatic method in the treatment of thoracic diseases. 

The author has aimed in this, as in previous editions, to 
present a succinct account of the articles of the Materia Medica 
in general use in the United States, and discussed in the courses 
of lectures delivered upon the subject, to which he trusts the 
work will be found, as heretofore, to furnish a suitable text-book. 
He takes pleasure in renewing his dedication of it to the gentle- 
men in attendance upon the various medical schools in North 

America. . 

John B. Biddle. 



CONTENTS 



PAGE 

Remedies — Definition of, 33 

Division of, 33 

PART I. 

MECHANICAL REMEDIES. 

General Bloodletting, 33 

Local Bloodletting, 34 

Leeches and Cups, 34 

Scarifications, 35 

Setons and Issues, 35 

Bandages, Frictions, 35 

Acupuncture, Baunscheidtismus, . . , 36 

Pneumatic Aspiration, 37 

PART II. 

IMPONDERABLE REMEDIES. 

Light, 38 

Heat, , . . 39 

Cold, 40 

Electricity, 41 

Massage, 45 

PART III. 

PHARMACOLOGICAL REMEDIES, OR MEDICINES. 

Medicines — Definition of, 46 

Modus operandi of, 48 

Circumstances which modify the Effects of, 49 

Forms in which they are used, 50 

Solids, 50 

Liquids, 52 

Semi-solids, 57 

Gases and Vapors, 58 

Weights and Measures, 58 

Effects of Age, Sex, Temperament, Idiosyncrasy, Habit, Disease, 

etc., upon, 61 

Parts to which medicines are applied, 64 

To the Skin, 64 

The Hypodermic method, 65 

To Mucous Membranes, 65 

Atomization, • 66 

To Serous Membranes, 69 

ix 



X CONTENTS. 

PAGE 

To Ulcers, "Wounds, Abscesses, etc., • . 69 

Intra-venous injection, 69 

Transfusion of Blood, 69 

Classification of Medicines, 70 

Class I. — Neurotics, 72 

Order I. Narcotics, 72 

Opium, 73 

Lactucarium, 84 

Paraldehyd, 85 

Hypnone, 87 

Urethan, 87 

Belladonna, 88 

Stramonium, 94 

Hyoscyamus, 95 

Duboisia, 98 

Cannabis Americana, 99 

Cannabis Indica, 99 

Humulus (Hops), 101 

Dulcamara (Bittersweet), 102 

Order II. Ethereal Anaesthetics, 102 

^Ether (Ether), 103 

Chloroformum (Chloroform) 107 

Methylene Bichloride, no 

Methylic Ether, in 

Nitrous Oxide Gas, in 

Ethyl Bromide, 112 

Local Anaesthesia, 112 

Order III. Antispasmodics, 113 

Asafcetida (Asafetida), 1 13 

Galbanum, 115 

Ammoniacum, (Ammoniac), 115 

Camphora (Camphor), 116 

Valeriana (Valerian), '. . . . 1 19 

Ammonii Valerianas (Ammonium Valerianate), 120 

Cypripedium, 120 

Scutellaria, 120 

Thea (Tea), 121 

Caffea (Coffee), 121 

Caffeina (Caffeine), 122 

Theobroma (Chocolate), 122 

Erythroxylon (Coca), 122 

Cocaine, 123 

Guarana, 128 

Mate, 128 

Moschus (Musk), 128 

Oleum Succini (Oil of Amber), 129 

Oleum ^Ethereum (Ethereal Oil), 130 

Spiritus ^Etheris Compositus (Compound Spirit of Ether), . . . 130 

Order IV. Tonics, 131 



CONTENTS. XI 

PAGE 

Vegetable Tonics, 132 

Simple Bitters, 132 

Quassia, 132 

Gentiana (Gentian) 133 

Calumba, 134 

Chirata, 135 

Aromatic Bitters, 136 

Serpentaria, 136 

Eucalyptus, 137 

Anthemis, 138 

Eupatorium, 139 

Absinthium, 140 

Magnolia, 141 

Cascarilla, 141 

Astringent Bitters, 141 

Cinchona, 141 

Quininae Sulphas (Quinine Sulphate), 150 

Quininge Bisulphas (Quinine Bisulphate), 151 

Quininae Valerianas (Quinine Valerianate), 151 

Quininae Hydrobromas (Quinine Hydrobromate), 151 

Quininae Hydrochloras (Quinine Hydrochlorate), 151 

Chinoidinum (Chinoidin), 152 

Cinchoninae Sulphas (Cinchonine Sulphate), 152 

Quinidinae Sulphas (Quinidine Sulphate), 152 

Cinchonidinae Sulphas (Cinchonidine Sulphate), 152 

Cornus, 153 

Salix, 154 

Prunus Virginiana (Wild Cherry), 154 

Digestive Ferments, 155 

Pepsinum (Pepsin), 155 

Pancreatinum (Pancreatin), 156 

Papaya, 157 

Mineral Tonics, 157 

Ferri Praeparata (Preparations of Iron), 157 

Mangani Praeparata (Preparations of Manganese), 168 

Acida Mineralia (Mineral Acids), 169 

Acidum Lacticum (Lactic Acid), 174 

Phosphorus, 176 

Zinci Phosphidum (Zinc Phosphide), 178 

Order V. Astringents, 178 

Vegetable Astringents, 179 

Acidum Tannicum (Tannic Acid), 179 

Acidum Gallicum (Gallic Acid), 180 

Galla (Nutgall), 181 

Catechu, 182 

Kino, 183 

Krameria, 184 

Haematoxylon, 185 

Quercus Alba (White Oak), 185 



Xll CONTENTS. 

PAGE 

Geranium, 186 

Hamamelis, 187 

Rosa Gallica (Red Rose), 188 

Rosa Centifolia (Pale Rose), 188 

Rhus Glabra (Sumach), . 188 

Rubus (Blackberry), 188 

Castanea (Chestnut), 189 

Mineral Astringents, : 189 

Plumbi Praeparata (Preparations of Lead), 189 

Cupri Praeparata (Preparations of Copper), 195 

Zinci Prasparata (Preparations of Zinc), 196 

Argenti Praeparata (Preparations of Silver), 198 

Bismuthi Praeparata (Preparations of Bismuth), 201 

Cerii Oxalas (Cerium Oxalate), 202 

Alumen (Alum), . . « 203 

Aluminii Sulphas (Aluminium Sulphate), 204 

Order VI. Stimulants, 204 

Diffusible Stimulants, , . 205 

Alcohol, 205 

Vinum (Wine), ' 209 

Spiritus Vini Gallici (Brandy), 210 

Spiritus Frumenti (Whisky), 210 

Spiritus Sacchari (Rum), 21© 

Spiritus Juniperi (Gin), ., 210 

Spiritus Myrciae (Spirit of Myrcia), 211 

Malt Liquors, 21 1 

Extractum Mai ti (Extract of Malt), 211 

Ammonias Praeparata (Preparations of Ammonia), 211 

Aromatics, 214 

Capsicum, 215 

Piper (Black Pepper) 216 

Cinnamomum (Cinnamon), , 216 

Myristica (Nutmeg), 217 

Macis (Mace), 217 

Caryophyllus (Cloves), 218 

Pimenta, 218 

Oleum Cajuputi (Cajeput Oil), 218 

Zingiber (Ginger), 219 

Cardamomum (Cardamom), 219 

Pulvis Aromaticus (Aromatic Powder), 220 

Extractum Aromaticum Fluidum (Aromatic Fluid Extract), . . . 220 

Calamus, 220 

Gaultheria, 220 

Aurantii Amari Cortex (Bitter-orange Peel), 223 

Aurantii Dulcis Cortex (Sweet-orange Peel), 223 

Those belonging to Nat. Ord. Labiatae, 223 

Menthol, 224 

Vinum Aromaticum (Aromatic Wine), 224 

Those belonging to Nat. Ord. Umbelliferae, 225 



CONTENTS. Xlll 

PAGE 

Illicium (Star Anise), 226 

Vanilla, 226 

Order VII. Sedatives, 226 

Aconitum (Aconite), 227 

Veratrum Viride, 232 

Veratrina (Veratrine), 236 

Pulsatilla (Pasque-flower), 237 

Arnica, 238 

Phytolacca, 239 

Staphisagria, 240 

Antimonii Pneparata (Preparations of Antimony), 241 

Potassii Nitras (Potassium Nitrate), 244 

Sodii Nitras (Sodium Nitrate), 246 

Refrigerants, 247 

Potassii Citras (Potassium Citrate), 247 

Liquor Ammonii Acetatis (Solution of Ammonium Acetate), . . 247 

Spiritus yEtheris Nitrosi (Spirit of Nitrous Ether), 248 

Acida Vegetabilia (Vegetable Acids), 248 

Order VIII. Spinants, 251 

Excito-motors, 251 

Nux Vomica, 251 

Strychnina (Strychnine), 257 

Strychninae Sulphas (Strychnine Sulphate), 257 

Ignatia, 257 

Hydrastis, 258 

Rhus Toxicodendron (Poison Oak), 259 

Cocculus Indicus, 259 

Picrotoxinum (Picrotoxin), 260 

Ergota (Ergot), 260 

Ustilago, 266 

Gossypii Radicis Cortex (Bark of Cotton Root), 267 

Digitalis, 268 

Adonidine, 273 

Strophantus, 274 

Sparteine, 275 

Cimicifuga, 276 

Depresso-motors, 278 

Conium, 278 

Physostigma, 281 

Chloral, 283 

Croton- Chloral- Hydrate, 286 

Potassii Bromidum (Potassium Bromide), 286 

Ammonii Bromidum (Ammonium Bromide), 290 

Sodii Bromidum (Sodium Bromide), 291 

Lithii Bromidum (Lithium Bromide), 291 

Calcii Bromidum (Calcium Bromide), 291 

Zinci Bromidum (Zinc Bromide), 291 

Acidum Hydrobromicum Dilutum (Diluted Hydrobromic Acid), 291 

Tabacum (Tobacco), 292 



XIV CONTENTS. 

PAGE 

Lobelia, 294 

Acidum Hydrocyanicum Dilutum (Diluted Hydrocjanic Acid), 296 

Potassii Cyanidum (Potassium Cyanide), 299 

Oleum Amygdala? Amarae (Oil of Bitter Almonds), 299 

Syrupus Amygdalae (Syrup of Almonds), t . 300 

Amyl Nitris (Amyl Nitrite), 300 

Nitroglycerinum (Nitroglycerin), 302 

Potassium Nitrite, 303 

Sodium Nitrite, 303 

Gelsemium, 304 

Woorara, 306 

Viburnum, _ 307 

Grindelia, 308 

Sumbul, 309 

Class II. — Eccritics, 310 

Order I. Emetics, 310 

Vegetable Emetics, 312 

Ipecacuanha (Ipecac), 312 

Sanguinaria, 317 

Apomorphinae Hydrochloras (Apomorphine Hydrochlorate), . . 317 

Sinapis (Mustard), 318 

Tobacco, 318 

Lobelia, 318 

Mineral Emetics, 319 

Order II. Cathartics, 319 

Laxatives, 320 

Tamarindus (Tamarind), 321 

Manna, 321 

Viola Tricolor, < 322 

Cassia Fistula, 323 

Oleum Olivae (Olive Oil), 323 

Oleum Amygdalae Expressum (Expressed Oil of Almond), . . . 323 

Oleum Ricini (Castor Oil), 323 

Sulphur, 325 

Potassa Sulphurata (Sulphurated Potassa), 326 

Saline Cathartics, 327 

Magnesia, ■ 328 

Magnesia Ponderosa (Heavy Magnesia), 328 

Magnesii Carbonas (Magnesium Carbonate), 330 

Magnesii Sulphas (Magnesium Sulphate), 330 

Liquor Magnesii Citratis (Solution of Magnesium Citrate), . . . 331 

Magnesii Citras Granulatus (Granulated Magnesium Citrate), . . 331 

Sodii Sulphas (Sodium Sulphate), 332 

Mangani Sulphas (Manganese Sulphate), 382 

Sodii Phosphas (Sodium Phosphate), 332 

Potassii Sulphas (Potassium Sulphate), ^33 

Potassii Bitartras (Potassium Bitartrate), 334 

Potassii Tartras (Potassium Tartrate), 334 

Potassii et Sodii Tartras (Potassium and Sodium Tartrate), . . . 334 



CONTENTS. XV 

PAGE 

Mild Acrid Cathartics, 335 

Rheum (Rhubarb), 335 

Juglans, 337 

Aloe (Aloes), 337 

Senna, 339 

Leptandra, 341 

Frangula, 342 

Cascara Sagrada, 342 

Drastic Cathartics, 343 

Jalapa (Jalap), 343 

Bryonia (Bryony), 344 

Podophyllum, 345 

Chelidonium, 347 

Iris, 348 

Euonymus, 348 

Scammonium (Scammony), 349 

Colocynthis (Colocynth), 350 

Cambogia (Gamboge), 351 

Elaterinum (Elaterin), 352 

Oleum Tiglii (Croton Oil), 353 

Mercurial Cathartics, 354 

Enemata, 355 

Order III. Diaphoretics, 356 

Pilocarpus, 357 

Alterative Diaphoretics, 360 

Sarsaparilla, 360 

Guaiaci Lignum et Resina (Guaiacum Wood and Guaiac), . . . 362 

Mezereum, 363 

Menispermum, 364 

Calendula, 364 

Sassafras, 364 

Stillingia, 365 

Order IV. Diuretics, 365 

Potassii Acetas (Potassium Acetate), 366 

Sodii Acetas (Sodium Acetate), 366 

Scilla (Squill), 367 

Colchicum, 369 

Oleum Erigerontis (Oil of Erigeron), 373 

Apocynum, 374 

Taraxacum, 375 

Triticum (Couchgrass), 376 

Juniperus (Juniper), 376 

Scoparius, 377 

Cantharis (Cantharides), 377 

Order V. Blennorrhetics, 378 

Senega, 378 

Quillaia, 380 

Allium (Garlic) , . 381 

Scilla (Squill), 382 



XVI CONTENTS. 

PAGE 

Terebinthina (Turpentine), . „ 382 

Chian Turpentine, 383 

Oleum Terebinthinae (Oil of Turpentine), 384 

Pix Liquida (Tar), 385 

Resina (Resin), 386 

Copaiba, 387 

Cubeba (Cubeb), 389 

Oleum Santali (Oil of Santal), ■ 391 

Matico, 392 

Pareira, 392 

Buchu, 393 

Uva Ursi, • ■ 393 

Chimaphila, 394 

Myrrha (Myrrh), 396 

Benzoinum (Benzoin), 396 

Styrax (Storax), 397 

Balsamum Peruvianum (Balsam of Peru), 398 

Balsamum Tolutanum (Balsam of Tolu), 398 

Order VI. Emmenagogues, 399 

Sabina (Savine), . . , 400 

Oleum Rutae (Oil of Rue), 401 

Tanacetum (Tansy), 401 

Apiol, 402 

Polygonum Hydropiperoides (Water-Pepper), . 402 

Class III. — Haematics, 403 

Order I. Haematinics, 403 

Order II. Alteratives, 403 

Hydrargyri Praeparata (Preparations of Mercury), 404 

Auri et Sodii Chloridum (Auric and Sodium Chloride), .... 423 

Iodum (Iodine), 424 

Potassii Iodidum (Potassium Iodide), 428 

Ammonii Iodidum (Ammonium Iodide), . ; 430 

Sodii Iodidum (Sodium Iodide), 431 

Sulphuris Iodidum (Sulphur Iodide), 431 

Iodoformum (Iodoform), . 431 

Iodol, 434 

Oleum Morrhuae (Cod-liver Oil), 436 

Arsenii Praeparata (Preparations of Arsenic), 439 

Calcii Phosphas Praecipitatus (Precipitated Calcium Phosphate), . 448 
Syrupus Calcii Lactophosphatis (Syrup of Calcium Lactophos- 

phate), 449 

Calcii Hypophosphis (Calcium Hypophosphite), 449 

Potassii Hypophosphis (Potassium Hypophosphite), 449 

Sodii Hypophosphis (Sodium Hypophosphite), 449 

Syrupus Hypophosphitum (Syrup of Hypophosphites), 449 

Syrupus Hypophosphitum cum Ferro (Syrup of Hypophosphites 

with Iron), 450 

Calcii Chloridum (Calcium Chloride) 450 

Ammonii Chloridum (Ammonium Chloride), 450 



CONTENTS. XV11 

PAGE 

Ammonii Phosphas (Ammonium Phosphate), 452 

Potassii Chloras (Potassium Chlorate), 452 

Sodii Chloras (Sodium Chlorate), 454 

Potassii Bichromas (Potassium Bichromate), 454 

Order III. Antacids, 454 

Potassii Prseparata (Potassium Preparations), 456 

Sodii Praeparata (Sodium Preparations), 458 

Lithii Praeparata (Lithium Preparations), 461 

Ammonii Praeparata (Ammonium Preparations), 462 

Magnesii Praeparata (Magnesium Preparations), 462 

Calcii Praeparata (Calcium Preparations), 462 

Class IV. — Topical Medicines. 

Order I. Antiseptics and Antipyretics, 464 

Potassii Permanganas (Potassium Permanganate), 466 

Aqua Chlori (Chlorine Water), 467 

Calx Chiorata (Chlorinated Lime), 467 

Liquor Sodae Chlorataa (Solution of Chlorinated Soda), .... 468 

Hydrargyri Chloridum Corrosivum (Mercuric Chloride), .... 468 

Bromum (Bromine), 470 

Iodum (Iodine), 470 

Hydrargyri Iodidum Rubrum (Mercuric Iodide), . 470 

Acidum Sulphurosum (Sulphurous Acid), 470 

Sodii Sulphis (Sodium Sulphite), 470 

Sodii Bisulphis (Sodium Bisulphite), 470 

Sodii Hyposulphis (Sodium Hyposulphite), 471 

Potassii Sulphis (Potassium Sulphite), 471 

Magnesii Sulphis (Magnesium Sulphite), 471 

Sulphides, 471 

Calx Sulphurata (Sulphurated Lime), 471 

Acidum Boricum (Boric [Boracic] Acid), 471 

Sodii Boras (Sodium Borate — Borax), 473 

Derivations of the organic radical, Phenyl, 473 

Phenyl Hydride (Benzine — Benzol), 476 

Acidum Carbolicum (Carbolic Acid), 476 

Sodii Sulpho-carbolas (Sodium Sulpho-carbolate), 480 

Creasotum (Creasote), 480 

Nitro-benzine, 482 

Aniline, 482 

Acetanilide (Antifebrin), 482 

Acidum Benzoicum (Benzoic Acid), 485 

Sodii Benzoas (Sodium Benzoate), 486 

Ammonii Benzoas (Ammonium Benzoate), 486 

Resorcin, 487 

Hydroquinone (Hydrochinone — Para-oxyphenol), 489 

Pyrocatechin (Ortho-oxyphenol), \ . 489 

Acidum Salicylicum (Salicylic Acid), 489 

Sodii Salicylas (Sodium Salicylate), ..... 492 

Lithii Salicylas (Lithium Salicylate), 49 2 

Salol, 492 



XV111 CONTENTS. 

PAGK 

Naphthaline, 495 

Naphthol, 497 

Pyridine, 497 

Chinoline, 498 

Kairine, 499 

Thalline, 500 

Antipyrine, 503 

Antiseptic Oils, 505 

Thymol, 505 

Order II. Irritants, 506 

Rubefacients, 506 

Sinapis (Mustard), - 507 

Capsicum, '. . . 510 

Oleum Terebinthinse (Oil of Turpentine), 510 

Linimentum Ammoniae (Liniment of Ammonia), 510 

Pix Burgundica (Burgundy Pitch), 510 

Pix Canadensis (Canada Pitch), 511 

Epispastics, 512 

Cantharis (Cantharides), 513 

Cantharis Vittata (Potato Fly), 517 

Aqua Ammonise (Water of Ammonia), 517 

Suppurants, 518 

Oleum Tiglii (Croton Oil), 518 

Unguentum Antimonii (Antimonial Ointment), 518 

Escharotics, 518 

Argenti Nitras Fusus (Fused Silver Nitrate), 519 

Potassa, 519 

Potassa cum Calce (Potassa with Lime), 520 

Soda, 520 

Acidum Chromicum (Chromic Acid), 520 

Acidum Arseniosum (Arsenious Acid) 520 

Bromum (Bromine), 521 

Zinci Chloridum (Zinc Chloride), 522 

Liquor Hydrargyri Nitratis (Solution of Mercuric Nitrate), . . . 522 

Potassii Bichromas (Potassium Bichromate), 522 

Acida Mineralia (Mineral Acids), 523 

Sapo Viridis (Green Soap), 523 

Chrysarobinum (Chrysophanic Acid), 524 

Order III. Demulcents 525 

Cataplasmata (Poultices), 5 2 ^ 

Aqua (Water), 527 

Acacia, 528 

Tragacantha (Tragacanth), 530 

Linum (Flaxseed), , . . . 53° 

Oleum Gossypii Seminis (Cotton-seed Oil), 532 

Ulmus (Slippery-elm Bark), 532 

Sassafras Medulla (Sassafras Pith), 533 

Althaea (Marshmallow), 533 

Oleum Sesami (Oil of Benne), 533. 



CONTENTS. XIX 

PAGE 

Cydonium (Quince Seed), 534 

Glycyrrhiza (Liquorice Root), 534 

Glycyrrhizinum Ammoniatum (Ammoniated Glycyrrhizin), . . . 535 

Extractum Glycyrrhizse (Extract of Liquorice), 535 

Lycopodium, 536 

Cetraria (Iceland Moss), 536 

Chondrus (Irish Moss), 537 

Amylum (Starch), 538 

Glyceritum Amyli (Glycerite of Starch), 540 

Ichthyocolla (Isinglass), 540 

Animal Fats, 540 

Adeps (Lard), 540 

Lanolin, 541 

Serum (Suet), 541 

Cetaceum (Spermaceti), 541 

Cera (Wax), * 542 

Acidutn 01 eicum (Oleic Acid), 542 

Oleum Theobromse (Oil of Theobroma), ..*...*... 542 

Glycerinum (Glycerin), 543 

Petrolatum, 545 

Pyroxylinum (Pyroxylin), 545 

Collodium (Collodion), 546 

Liquor Gutta Perchae (Solution of Gutta Percha), 546 

Liquor Sodii Silicatis (Solution of Sodium Silicate), 547 

Saccharum (Sugar), 547 

Mel (Honey), 548 

Saccharum Lactis (Sugar of Milk), 548 

Saccharin, 548 

Carbo Ligni (Charcoal), 549 

Order IV. Coloring Agents, 550 

Crocus (Saffron), 550 

Santalum Rubrum (Red Saunders), 550 

Coccus (Cochineal) - 550 

Order V. Anthelmintics, ... 551 

Spigelia, 551 

Chenopodium, . . . . * 553 

Santonica, 554 

Santoninum (Santonin), 555 

Sodii Santoninas (Sodium Santoninate), 556 

Azedarach, » 556 

Aspidium, 556 

Granatum (Pomegranate), 557 

Oleum Terebinthinae (Oil of Turpentine), 558 

Calomel, 558 

Bray era (Koosso), . . . 558 

Kamala, 559 

Pepo (Pumpkin Seed), 559 

Appendix, 560 

Signs and Abbreviations, 561 

Index, 563 



MATERIA MEDICA. 



The agents employed in the treatment of diseases are denom- 
inated Remedies, and the branch of medicine which is devoted 
to their consideration is termed Materia Medica. Remedies 
may be divided into Ffygienic, Mechanical, Imponderable, and 
Pharmacological agents. 

Hygienic Remedies are usually treated of in works specially 
devoted to the subject. 



PARTI. 

MECHANICAL REMEDIES. 

Mechanical Remedies belong chiefly to Surgery. A few 
agents of this class being, however, employed in the practice 
of medicine, are included in the Materia Medica. They are 
blood-letting (general and local), setons, issues, ba7idages, friction, 
acupuncture, and aspiration. 

I. General Blood-letting is performed principally by vene- 
section ox phlebotomy, which is usually practiced on the median- 
cephalic or basilic veins of the arm — sometimes also on the 
external jugular and other veins. From the veins at the elbow 
it is done by passing a ligature above the point selected, the 
patient being in the sitting posture, and making an incision in 
the most prominent vein ample enough to permit f§ij-iij of 
blood to escape per minute, and allowing it to flow until syn- 
cope approaches. To stop the flow, remove the ligature, apply 
a compress, and place the patient in the recumbent posture. 
3 33 



34 MATERIA MEDICA. 

Aricriotomy is occasionally resorted to, on the temporal artery, 
in cerebral affections. 

Blood-letting is employed to moderate vascular excitement, 
reduce inflammatory action, alter the quality of the blood 
(diminishing the proportion of fibrin, albumen and salts), 
relieve congestion, allay spasm and pain, relax the muscular 
system, promote absorption, arrest hemorrhage, remove stasis, 
and prevent cell proliferation and inflammatory effusions, and 
for these purposes it has long been considered a valuable thera- 
peutical resource. So powerful and exhausting an agent is, 
however, always to be resorted to with caution and discrimina- 
tion ; is not to be unduly repeated, even in inflammatory cases ; 
and is seldom or never proper in disease of a typhoid tendency, 
or where a tubercular diathesis is suspected, or in extreme 
infancy and old age. It is indicated in inflammations of sthenic 
type occurring in robust adults, and accompanied by a full, 
bounding, tense pulse, and should only be resorted to early in 
the case, before inflammatory effusions have taken place. 

2. The Local Abstraction of Blood is practiced by means 
of leeches, cups, and ' scarifications. When a leech is applied 
between the inflamed area and the heart the blood current is 
accelerated, stasis removed or prevented, as is also the migration 
of cells and the effusion of serum. Scarifications produce the 
same results in a less degree and also give vent to effused fluids. 
The leech (liirndd) is an annulated aquatic worm, with a flattened 
body, tapering toward each end and terminating in circular flat- 
tened disks, which is found throughout Europe, America and 
India. The European leech (Ii. medicinalis, termed also sangui- 
suga officinalis) is of a blackish or grayish-green color on the 
back, from two to three or four inches in length, and is charac- 
terized by six longitudinal dorsal ferruginous stripes, the four 
lateral ones being interrupted or tessellated with black spots. It 
draws about f 5ss. The American leech (li. decora) is usually 
from two to three inches long, and is of a deep green color, with 
three longitudinal dorsal rows or square spots. Both the im- 
ported and indigenous leech are employed in this country, but 
the latter makes a smaller incision, and is preferable in infantile 
cases. It takes about f5j. When the discharge of blood from 
leech-bites is excessive, it may be arrested by pressure, com- 



MECHANICAL REMEDIES. 35 

presses of lint, the application of alum, creasote, solution of iron 
subsulphate, and other styptics, or by cauterizing the wound 
by silver nitrate or a red-hot probe ; and if these means fail, the 
lips of the wound may be sutured. 

In the operation of cupping, cupping-glasses and a scarificator 
are employed. The removal of atmospheric pressure, by the 
application of glasses partially exhausted of air, produces a deter- 
mination of blood to the capillaries of a part, which is afterward 
readily drawn by scarification. When blood is not abstracted, 
the operation is termed dry cupping, and is a valuable revulsive 
agent. The topical abstraction of blood by leeches and cut cups 
combines the advantages of depletion and revulsion. Leeches 
are employed in external inflammations, in situations where 
cups are inadmissible, and in infantile cases. As leech-bites 
make scars, they should be cautiously applied over an exposed 
part, as the female face ; nor should they be used where there is 
much loose connective tissue, as the scrotum and eyelid ; over 
a superficial vessel or nerve ; over the seat of morbid action, nor 
in the vicinity of locally infective wounds, as venereal ulcers. 
Cups are generally preferable in internal inflammations, from 
their more decided revulsive influence. When blood is drawn 
by leeches, its continued flow may be promoted by the applica- 
tion of warm fomentations to the wounds. 

Scarifications are slight incisions made in inflamed parts, to 
relieve the engorged capillary vessels ; they are often employed 
with benefit in inflammation of the conjunctiva and of the ton- 
sils. 

3. Setons (setaced) and Issues (fonticuli) were employed when 
a permanent counter-irritant effect was desired. They are now 
not much used. 

4. Bandages are employed, in the practice of medicine, to 
promote the absorption of dropsical effusions, and solid inflam- 
matory exudations. For the same purpose strips of adhesive 
plaster may be applied to the chest, in chronic pleurisy and 
empyema, in the manner in which they are employed in the 
treatment of fractured ribs. 

5. Frictions are useful as revellents and as local stimulants. 
They may be employed either with the dry hand or with horse- 
hair gloves, or with liniments. The latter, applied with a sponge, 



36 MATERIA MEDICA. 

are serviceable in lumbago, sciatica, chronic rheumatism, and 
affections of the joints ; rubbed on the chest in bronchitis they 
often afford relief. 

6. Acupuncture consists in the introduction into the body of 
fine, well-polished, sharp-pointed needles ; they are introduced 
by a rapid rotary motion. This is a useful remedy in rheuma- 
tism, neuralgia, and local paralysis. By the use of insulated 
needles a galvanic current may be conveyed to deeply-seated 
nerves. For purposes of counter-irritation a form of acupunc- 
ture is now used termed Baunscheidtismus. In this, an instru- 
ment is employed consisting of a heavy disk about half an inch 
in diameter, having inserted in it about twenty-five sharp needles, 
each about nine-sixteenths of an inch in length. To this disk is 
attached a strong wire spiral spring five and a half inches in 
length, and the other extremity of the spring is inserted in an 
elongated spindle-shaped handle, the spring and needles being 
contained in a cylinder, with the handle attached. In applying 
the instrument the open extremity of the cylinder is placed upon 
the skin ; the handle is drawn up, and when this is suddenly 
loosed the needles are driven into the skin, the punctures being 
afterward rubbed with diluted croton oil or other irritant. 

7. Pneumatic Aspiration is the employment of an instru- 
ment termed an Aspirator (invented by Dieulafoy) for the 
removal by suction of pathological fluids. 

The aspirator consists of: — 

1. A glass bottle or reservoir, A, mounted with a two-way 

stop-cock, B, and having an opening at the bottom for the 
insertion of the tube, C. 

2. An exhausting syringe, D, with elastic connecting-tube, H. 

3. A tubular needle, E, to be attached to the reservoir by an 

india-rubber tube, F. 

A syringe and stop-cock for injecting astringents or other 
fluid is supplied if desired. The stop-cock is, in such 'cases, fixed 
to the tube F at its junction with the stop-cock B. Thus the 
tube can be detached from the aspirator without any chance of 
air entering the morbid cavity. 

Directions for Use. — Adjust the aspirator as figured in the 
diagram, with the stop-cock B turned vertically, that is, open to 
the bottle ; close the stop-cock in the tube C, and form a vacuum 



MECHANICAL REMEDIES. 



37 




38 MATERIA MEDICA. 

by a few upward and downward movements of the piston of the 
exhausting syringe D. 

Insert one of the needles beyond the two eyes, attach tube 
F to it, turn the stop-cock B toward the needle, namely, hori- 
zontally, and continue the insertion of the needle until fluid is 
seen to flow through the short glass tube G into the reservoir. 

To empty the latter, turn the stop-cock B vertically, detach 
the syringe tube, and open the stop-cock in tube C. 

The presence of fluid having been established by the use of 
one of the fine needles, it is recommended, for more quickly 
emptying the cavity, to use one of the larger needles or trocars. 

The introduction of the needle into the tissues requires some 
precautions. In place of endeavoring to penetrate by pressure, 
as with an ordinary trocar, it is preferable to combine pressure 
with rotation, by taking the needle in the forefinger and thumb 
and rolling it between them. Such a manoeuvre is rendered 
necessary by the extreme fineness of the needle, which would 
be liable to bend or twist if driven in by direct pressure. Before 
using a needle it is well to be assured of its permeability. 

Aspiration has been employed with safety and success in the 
removal of intrathoracic effusions (as in chronic pleurisy, empy- 
ema, and pericarditis), of the fluid of hydrocephalus, ascites, 
cysts and abscesses of the liver, of the urine in retention, and 
of poisonous liquids in the stomach. It is also applicable to the 
diagnosis and treatment of morbid fluids and to the arrest of 
internal hemorrhage. 

Aspiration should be done under strict antiseptic precautions. 



PART II. 

IMPONDERABLE REMEDIES. 

Under this head are included Light, Heat, Cold, Electricity, 
and Massage. 

1. Light (Lttx) exercises an important influence in the organ- 
ized world as a vivifying stimulus. It is useful as a therapeutic 
agent, in diseases dependent on imperfect nutrition and sangui- 



IMPONDERABLE REMEDIES. 39 

fication ; and the exposure of the surface of the body to its 
action, as far as nudity is compatible with proper warmth, pro- 
motes the regular development and strength of the organs. On 
the other hand, in many diseases the action of light is injurious, 
and darkness is resorted to as a sedative and tranquilizing agent. 

2. Heat {Calor), applied to the human system in moderate 
amount, acts, both locally and generally, as a stimulant ; in 
intense degree it destroys vitality and organization. It is em- 
ployed as a local excitant and revulsive, by means of hot bottles, 
hot bricks, the hot foot-batji, etc., and as an application to pain- 
ful and inflamed parts in the form of elastic bags containing hot 
water, and of poultices and fomentations. As a general appli- 
cation heat is chiefly resorted to in the form of the water-bath 
and vapor-bath. The warm bath, at a temperature from 92 to 
98 F., is used as a relaxant in dislocations, herniae, spasm, 
infantile convulsions, croup, etc., and also for its action on the 
skin in rheumatic and chronic cutaneous affections. The hot 
bath has a temperature of from 98° to 11 2°, or even higher, and 
is a powerful excitant in cases of exhaustion, asphyxia or suffo- 
cation, alleviates the strangury of cystitis and gonorrhoea, and 
is employed also in old paralytic and rheumatic cases. Hot 
water, introduced with a Davidson's syringe, is an efficient 
styptic in uterine hemorrhage ; injected into the vagina before 
an operation on the perineum or cervix, or applied to wounds 
during a surgical operation, is a good means of avoiding bleed- 
ing. The hot-air bath, at a temperature of from 98 to 130 , is 
useful as an excitant, diaphoretic and revellent, and is employed 
in cases of internal congestion, to produce vicarious action from 
the skin, where the secretion from other organs, as the kidneys, 
is suspended, and in rheumatic, neuralgic, and cutaneous affec- 
tions. The hot-vapor bath is adapted to the same class of cases 
as the hot-air bath, and exerts a more marked diaphoretic and 
relaxing influence. 

The destructive agency of heat is resorted to for the purpose 
of vesication, as by the application to the skin of the metallic 
plate heated to 21 2° by immersion in boiling-water; and of 
cauterization, by the employment of red-hot iron, or of moxa. 
Hot iron (known as the actual cautery) is used chiefly as a 
styptic. The term moxa is applied to small masses of combus- 



40 MATERIA MEDICA. 

tible matter (as cotton-wool), which are burnt slowly in contact 
with the skin, with a view to a revulsive effect in deep-seated 
inflammations, nervous affections, etc. 

3. Cold (Frigus). — The application of cold to living- bodies 
produces a reduction of the temperature and volume of the 
parts, with contraction of the blood vessels and other tissues, 
and suspension of the secretions and exhalations. The applica- 
tion of excessive or prolonged cold is followed by the torpor 
and death of the parts. When it is applied in moderation and 
for a short period, reaction generally takes place, with a return 
and even increase in temperature, volume, color, and sensibility. 

Cold is employed therapeutically, with a view to both its pri- 
mary and secondary effects. The primary action of cold is used : 
1. To lessen vascular and nervous excitement and preternatural 
heat, as by the use of cold lotions and spongings in fevers, the 
ice-cap in cerebral affection, the shower-bath in insanity, the 
bladder filled with ice to the spine in epilepsy, the ether spray 
to the spine in chorea, etc. 2. To constringe the tissues, pro- 
mote the coagulation of the blood and lessen the volume of 
parts ; hence the local application of ice or cold water to abate 
inflammation, check hemorrhage, cure aneurism, and reduce 
strangulated hernia. 3. To produce local anaesthesia in surgical 
operations, by means of a freezing mixture topically applied. 

The secondary effects of cold are obtained by the employment 
of a less intense degree of cold. They are resorted to : I. To 
invigorate the system, as with the cold shower-bath and plunge- 
bath. 2. To rouse the system, as by cold affusions in coma, 
asphyxia, syncope, and the narcotism from opium, chloroform, 
hydrocyanic acid, alcohol, etc. 3. In spasmodic diseases, as 
laryngismus stridulus, chorea, etc. 4. To recall the vital pro- 
perties to frost-bitten parts. 5. To effect local excitation, as by 
the application of the cold douche to rheumatic and paralyzed 
limbs. 

The cold bath, or packing in a cold wet sheet, is employed 
with much advantage in sunstroke, and in fevers where the tern- 
perature of the body is very high, as scarlet fever, typhoid fever, 
acute rheumatism, and, generally, to reduce excessive hyper- 
pyrexia. 

The ice-bag is sometimes applied along the spine in convul- 



IMPONDERABLE REMEDIES. 4 1 

sive diseases, as epilepsy, tetanus, and infantile convulsions, and 
even in diseases of the secreting organs. 

Compresses, wrung out of cold water, are efficient local appli- 
cations in relieving pain. 

Cold liquids and ice are taken into the stomach as refrigerants 
in fevers. They are introduced into the rectum and vagina to 
check hemorrhage and allay irritation ; and cold water, injected 
into the impregnated uterus, is among the most certain means 
of inducing premature delivery. Baths are also useful in pro- 
moting the elimination of mineral poisons, as lead and mercury. 

Electricity {Electricitas), from yjXexrpov, amber. " Electricity is 
now regarded as a force co-related to the other great forces of 
nature — heat, light, etc. — and, like them, is simply a mode of 
motion — a force of vibration." (Beard and Rockwell.) The 
electric current acts as an excitant to the nerves, both of sensa- 
tion and motion. It influences also to some extent the secre- 
tions, through its action on the nerves distributed to the secreting 
organs ; it may promote the function of absorption, through an 
effect on the absorbents ; and it affects the circulation by induc- 
ing contractions of the heart and of the coats of the vessels. 
Faradisation of the peripheral ends of the cut pneumogastrics 
stops the action of the heart ; of the central ends, it causes re- 
tarded action and reduced blood pressure. A powerful charge 
of electricity produces violent and frequently fatal effects on the 
central nervous system. 

For medical purposes electricity is obtained from three 
sources : — 

i. Friction or Static electricity. 

2. Galvanic electricity. 

3. Faradic, Induced, Magnetic or Voltao-Magnetic elec- 
tricity. 

Friction electricity may be applied in three modes : — 

1. By the electric bath, when the patient, placed upon an insu- 
lated stool and connected with the prime conductor of an elec- 
trical machine, is charged with electricity. 

2. By a spark to a particular spot ; or, 

3. A shock through a charged Leyden jar may be directed 
through the part which it is desired to affect. 

Galvanism is that form of electricity which is developed by 



42 MATERIA MEDICA. 

chemical decomposition, and is known as the continuous, vol- 
taic, or battery current. It is characterized by relatively low 
intensity of action, but is developed in considerable quantity, 
and produces chemical and thermic results that are not reached 
by the friction electricity. In addition, it induces a flow of blood 
to a part by increasing the vermicular action of the vessels. 
Galvanism, no matter what the direction of the current, is a 
powerful agent in the relief of pain, hence its use in tic doulou- 
reux, but it is only palliative in this disease. 

Faradisation, or Induced electricity, is applied by means of 
electro-magnetic machines, their principle depending on the 
passage of a battery current through an insulated wire helix 
wrapped round a soft iron bar, which becomes magnetic by in- 
duction. Around this helix a fine insulated wire is coiled, which 
has no connection with the battery nor primary helix, and which 
receives electricity by induction from the latter. Closure of the 
current magnetizes the bar, which, in turn, attracts the rheotome ; 
on breaking the flow the bar becomes demagnetized, the rheo- 
tome flies back, and in this way an interrupted current is obtained. 
The polarity of the induced current changes with each make 
and break of the circuit, and of course is inconstant, because its 
direction is constantly alternating ; hence no chemical action is 
set up. If the interruptions be rapid enough, they cause appa- 
rently continuous muscular contractions. 

The primary current is taken from the inner helix ; the sec- 
ondary from the outer. The electrodes are the means by which 
the positive and negative electricity emerge from the battery; 
the positive pole being connected with the negative element, 
and the negative pole with the positive element. A stabile 
application is one in which the electrodes are kept in a fixed 
position ; in a labile, they are shifted from point to point. 
Before use they should be moistened to increase their conduc- 
tivity. Magneto-electricity is inferior in chemical and thermal 
influence to galvanism, but it produces more marked muscular 
contractions, and a more decided action on both the sensory and 
motor nerves. The brain substance, as shown by Erb, is readily 
affected by galvanism from the exterior, for when the electrodes 
are applied to the mastoids, flashes of light and vertigo are ex- 
perienced ; but, according to Althaus, the former phenomenon 



IMPONDERABLE REMEDIES. 43 

is due to excitation of the fifth nerve. Of the cord, galvanism 
causes muscular contractions and pain. 

Electricity is employed in medicine for diagnostic and thera- 
peutic purposes. Thus, in the diagnosis of spinal paralysis : 
when a muscle is merely separated from the influence of the 
spinal cord by destruction of its nerve, or by destructive disease 
of the cord at the origin of its nerve, it loses its electric irrita- 
bility to all forms of electric irritation. In cerebral paralysis, on 
the other hand, there is no diminution in the contractility of the 
paralyzed muscle by the electric current, and there may be even 
an increase. In malingering, real may be distinguished from 
feigned paralysis, as, after railway accidents, faradisation, by 
showing a marked difference in the contractility of the two sides* 
establishes the fact of an actual morbid condition. 

In facial palsy the diagnostic value of electricity is typically 
evinced. Thus, the muscles respond scarcely, or not at all, to 
the faradic current in this condition, while the galvanic current 
will induce normal, or nearly normal, contractions. 

In recent hysterical paralysis the contractility of the muscles is 
unimpaired. 

Therapeutically \ electricity may be employed either to arouse 
or increase the action of a nerve or muscle, as in paralysis of 
sensation or of motion, to relieve the pain of the various neural- 
gias, and to counteract spasm, either tonic or clonic. For the 
latter galvanism only is used, the positive pole being connected 
with a large plate electrode which is placed over the spastic 
muscles, while the negative is applied over a neutral point in the 
median line of the body. It is chiefly available in cases of local 
or of purely functional palsy, as facial, and the paralysis pro- 
duced by alcohol, which are independent of central lesions ; or 
in lead palsy after the elimination of the lead from the system. 

In the treatment of facial palsy the positive pole of the gal- 
vanic current is to be placed over the pes anserinus, the negative 
on the terminal nerve filaments. Lumbago, neuralgia, chronic 
rheumatism and migraine are frequently benefited by a course 
of electricity. In migraine the current should be passed from 
the nape of the neck to the epigastrium. 

But little can be said in favor of electricity in dermal thera- 
peutics, though good results are claimed for it in chronic eczema 



44 MATERIA MEDICA. 

(Rothwell) centrally and locally. It has also been used in acne, 
prurigo, and psoriasis. In anaemic and hysterical paralysis, as 
hysterical aphonia, static electricity is often very useful, and in 
nervous deafness and amaurosis, under many circumstances, 
faradisation will be of benefit. 

Electricity has also been prescribed as an emmenagogue, to 
produce uterine contraction in post-partum hemorrhage, in test- 
ing for life or death, to overcome constipation, and to promote 
the biliary secretion. 

In the form of galvanism, one pole in the rectum, the other 
over the abdominal tumor, electricity is employed to destroy 
the foetus in extra-uterine pregnancy, provided foetal life has not 
advanced too far. It has also been advantageously used to pro- 
mote the absorption of indurations and fibroid tumors. Electro- 
magnetism is a powerful excitant in the coma of narcotic poisons, 
and in asphyxia generally it is probably the most active remedy 
that can be exhibited. 

Electrolysis. — " This is a term applied to the process of decom- 
posing substances by electricity." It is used with decided suc- 
cess to remove superfluous hairs from the face and other parts. 
Pitzer recommends the following procedure : an ordinary gal- 
vanic battery of 10-15 cells is required, with a fine needle, which 
is attached to the negative pole. The needle is inserted within 
the hair follicle and the current closed with the positive electrode, 
causing a stinging sensation at the point of insertion ; the hair 
should then be withdrawn with forceps ; thirty to fifty hairs can 
be removed at one seance. 

Electrolysis has been used in the treatment of aneurism, but 
with a measure of success only. One or more needles con- 
nected with the positive pole are inserted within the sac in the 
hope of forming a clot by the ensuing electrolytic action of the 
current on the blood. The negative pole is to be applied to the 
shoulder, the current turned on slowly, and the seance should 
last about twenty minutes. Statistics show that the smaller the 
artery the greater the chance of occlusion. The chief dangers 
are hemorrhage and the detachment and drifting into the blood 
of coagula. 

In urethral stricture the galvanic current in a certain propor- 
tion of cases effects a cure. Mild currents must be employed 



IMPONDERABLE REMEDIES. 45 

and applied to the seat of constriction per the negative pole by 
means of conical metal bulbs attached to bougies. 

Galvano-cautery. — This is a method of cauterization in which 
a wire-loop or other suitable cauterant is heated by the galvanic 
current. Experiment has shown that the heat developed in a 
wire by a current is proportional to the squares of the quantity 
of electricity flowing through it and to the resistance of the 
wire. 

Platinum, on account of its great resisting power, is the kind 
of wire selected. The chief advantages of the galvano-cautery 
are : easy application to inaccessible parts, absence of hemor- 
rhage, and comparatively little pain. 

Massage. — This is a word derived from the Greek, ijA<7<ju), I 
knead ; Arabic, mass, press softly. Massage has been in use by 
the ancients from time immemorial. It is now defined to mean 
a series of digital and manual movements applied to the body 
for therapeutic purposes, and by some authors is designated 
mechano-therapy. There are four kinds of movements in vogue, 
viz., Effleurage, Petrissage, Tapotement, and Massage a friction. 
The first consists in gentle centripetal palmar stroking of the 
surface ; the second of picking up and kneading the soft parts 
with the fingers ; the third of percussion with the fingers, hands 
or knuckles ; the fourth of elliptical frictions in narrow circles. 

The art or act of massageing consists in the suitable combina- 
tion of these movements, and, in order to obtain their best thera- 
peutical effects, should only be employed under medical advice, 
and administered by an expert. Inasmuch as action and reac- 
tion are equal, an individual cannot massage himself; moreover, 
there is an extraneous mesmeric influence involved, so conducive 
to its effectual performance, that renders this impossible. 

Physiologically, massage produces a calming effect on the ner- 
vous system, stimulates the flow of the blood and lymph, affords 
gentle exercise to the muscles, facilitates absorption, and ele- 
vates the body temperature about i°. It does, in a word, con- 
tribute to restoring the body to health by arousing to renewed 
and normal activity all the vital processes, and, unlike internal 
medication, is not followed by reaction, of whatever degree of 
severity. 

Therapy. — Massage is employed with advantage in paralysis, 



4-6 MATERIA MEDICA. 

writer's cramp, locomotor ataxia, chronic rheumatism, lumbago, 
neurasthenia, and spinal irritation. In fact, whenever there is 
loss of power, stiffness, or pain in an accessible part, massage 
will nearly always afford relief. In chronic rheumatism, as in 
other affections where its employment seems advisable, a com- 
bination of massage with electricity will often be of benefit. In 
all cases the duration and frequency of the seances must be left 
to the discretion of the physician, and regulated by the nature 
of the disease. 

As to the length of time required to accomplish definite results 
with massagre, Eccles* finds that in one month's massage an in- 
crease of strength, body weight and appetite, with ability to sleep 
and work well, may be expected. Massage of the abdomen, accord- 
ing to Rubens-Hirschberg,f increases the quantity of the gastric 
juice, lessens dyspeptic pains, and augments the urinary flow. 

Even in health, after violent exercise, general friction of the 
body augments the vigor of the system, and consequently plays 
an important part in all methods of training. 

Under this heading mention must be made of the Weir- 
Mitchell treatment of neurasthenic disorders, which, in addition 
to massage, consists of isolation, rest, over-feeding, and electri- 
city ; and also of the 

Swedish Movement cure, which is defined by Schreiber to con- 
sist " in presenting a resistance to the intended motion of the 
patient, either by the physician himself or by an assistant." 



PART III. 

PHARMACOLOGICAL REMEDIES. 
Pharmacological Remedies, or Medicines, are substances 
not essentially alimentary, which, when applied to the body, so 
alter or modify its vital functions as to be rendered applicable 
to the treatment of diseases. Pharmacology, accordingly, treats 
of the physiological action of drugs. For convenience of study 

* The Practitioner, 1 887, p. 401. 

f Bull. Gen.de Thirap., Sept. 30th, 1887, p. 241. 



PHARMACOLOGICAL REMEDIES. 4/ 

the action of medicines is divided into local and internal: they 
are termed local when applied directly to a part (cauterants, for 
example) ; internal, when the economy is affected, as by way of 
the stomach, rectum, or hypodermically. This division is arbi- 
trary, since the local application of many substances eventually 
exerts an influence on the system. 

The designation Materia Medica is, strictly speaking, limited 
to the consideration of the nature and properties of the remedies 
used in medicine. The application of medicines to the treatment 
of diseases is termed Therapeutics. Pharmacy is the department 
of Materia Medica which treats of the collection, preparation, 
preservation, and dispensation of medicines. 

To the student of medicine, the objects of examination in 
relation to medicines are — the sources from which they are 
derived ; the mode in which they are prepared and brought to 
market ; their sensible qualities, and also their chemical compo- 
sition and relations ; their physiological effects, or the effects 
which they are capable of producing in healthy individuals ; 
their therapeutical effects, or those which they produce in morbid 
states of the system ; and, lastly, the doses, modes of adminis- 
tration, and preparations (extemporaneous and officinal), under 
which they are administered. 

To facilitate a uniform nomenclature and dispensation of medi- 
cines, authoritative works have been issued in different countries, 
termed Pharmacopoeias. The Pharmacopoeia of the United 
States was first promulgated by the authority of a convention 
held at Washington, in 1820, and it has since been revised decen- 
nially. It furnishes a list of articles which are in general use, 
describes tests for their purity where required, sets forth the 
weights and measures which are employed in dispensing and 
preparing them, and supplies formulae for such preparations as 
should be kept in the shops, and which are thence termed officinal, 
from the Latin word officina, a shop. " All the articles are 
arranged in a continuous alphabetical order," and in no instance 
is the dose given. A Dispensatory differs from a Pharmacopoeia 
in containing the medical and physical history of the various 
substances with directions for dispensing the same; the Pharma- 
copoeia is mainly restricted to the mode of preparing them ; it is 
officinal, while the Dispensatory is not. 



48 MATERIA MEDICA. 

MODUS OPERANDI OF MEDICINES. 

The medium through which the influence of medicines is 
exerted on remote parts of the body, or their modus operandi 
(as it is usually termed), was long a contested point, but it is now 
generally admitted that the absorption or passage of the medicinal 
or poisonous molecules into the blood is necessary to their action 
on parts remote from the seat of impression. It was Magendie 
who first conclusively demonstrated that poisons act on the 
spinal cord through the circulation, and not by means of the 
lymph and nerves. 

While, however, it is well established that the characteristic 
action of medicines is transmitted to the parts influenced, exclu- 
sively through the medium of the circulation, it is undeniable 
that the functions of the nervous system may be secondarily 
excited by a local medicinal impression. The number of agents 
which operate in this manner is, however, very limited. 

The action of medicines by absorption is proved by a variety 
of facts. 

They are detected in many parts of the system remote from 
that to which they have been applied, having been found in the 
blood, the solids, and the excretions, after being taken into the 
stomach. If the circulation be interrupted, the influence of a 
poison cannot be transmitted ; while its effects have been obtained, 
when applied to a wound in the foot of an animal, after all parts 
of the extremity have been severed except the artery and vein. 
In confirmation of the doctrine of absorption may be cited also 
the admitted facts, that the remote effects of medicines or poisons 
are promoted or retarded by circumstances which promote or 
retard absorption ; that the blood of poisoned animals is found 
to possess poisonous properties ; that the fluids and solids acquire 
medicinal properties after the use of medicines (as the milk of 
nurses) ; that the specific effects of medicines are produced by 
their injection into the blood ; and that medicines disappear from 
closed cavities into which they are introduced. 

After their absorption into the blood, medicines circulate 
with it, penetrate through the capillaries to the various organs, 
and are afterward thrown out of the system with the excretions. 
Some medicines produce changes in the condition of the circu- 
lating fluid. Others have a specific action upon some one or 



PHARMACOLOGICAL REMEDIES. 49 

other of the organs of the body. And, in passing out of the 
system, most medicines act as excitants of the organs by which 
they are thrown out. 

The absorption of medicines is effected principally by the 
capillaries, and in some degree also by the lymphatics and lac- 
teals. The medicinal particles penetrate or soak through the 
interstices of the tissue with which they are placed in contact, 
and are thence diffused through the circulation. To a limited 
extent, medicinal substances probably penetrate all the tissues 
of the part to which they are applied, and in this way the activity 
of medicines is most decided upon the organs contiguous to the 
seat of application. 

The absorption of insoluble substances cannot take place 
until they are previously rendered soluble. In the stomach, this 
is accomplished partly by the agency of the acids of digestion 
and partly by the albuminoid constituents of the gastric fluid. 
Some substances are dissolved by the alkaline liquids of the 
small intestine. 

It is objected to the theory of the operation of medicines by 
absorption, that certain poisons act with a rapidity incompatible 
with their previous introduction into the circulation. This is, 
however, not the fact, as the action of the most violent poisons 
(hydrocyanic acid, for example) is never wholly instantaneous ; 
and careful experiments have shown that the velocity of the 
circulation is sufficient to diffuse a poison through the blood in 
a shorter space of time than its effects are ever observed on the 
system. 

CIRCUMSTANCES WHICH MODIFY THE EFFECTS OF MEDICINES. 

The circumstances which modify the effects of medicines 
relate both to the medicines and to the human system. 

1. The properties of medicines are modified by the soil in 
which they grow, by climate, cultivation, age, and the season of 
the year at which they are gathered. 

2. Medicines are more active, because more readily absorbed, 
in a state of solution than in a solid state. 

3. Soluble medicines are often rendered inert by a chemical 
reaction which converts them into insolubles, or by a physio- 
logical antagonism, exerted by some other medicine taken at or 

4 



50 MATERIA MEDICA. 

about the same time, which counteracts their effects throughout 
a part or the whole of their range of action ; in this way chemi- 
cal and physiological antidotes modify the effects of poisons. 
When the chemical composition of medicines involves their 
mutual decomposition, they are said to be incompatible. 

4. Differences in dose greatly modify the effects of medicines. 

5. Pharmaceutical modifications have an important influence 
on the efficacy of medicines. They may be exhibited in the 
solid, semi-solid, liquid and aeriform states. 

In the solid state they are administered in the shape of ab- 
stracts, triturations, powders, pills, lozenges, confections and 
papers. 

In the liquid state they are administered in the shape of 
mixtures, solutions, medicated waters, infusions, decoctions, 
tinctures, spirits, wines, juices, vinegars, honeys, syrups, fluid 
extracts, glycerites and oleo-resins. 

In the semi-solid or soft state they are employed internally, 
in the form of suppositories and extracts ; and externally in that 
of liniments, ointments, cerates, oleates, plasters, and cataplasms. 

In the form of gases and vapors, medicines are used for pur- 
poses of inhalation. 

SOLIDS. 

Abstracts {Abstractd) are solid preparations in the form of 
powder. They are twice as strong as the drug or the fluid ex- 
tract, and are about ten times as strong as the tincture, and are 
alcoholic extracts, diluted with sugar of milk. 

Triturations {Triturationes) are prepared by thoroughly tritu- 
rating in a mortar, 10 parts of the medicinal substance with 90 
parts of sugar of milk (which should be gradually added, and 
the process continued until the whole is thoroughly mixed and 
finely powdered). 

Powders (Pulveres). The form of powder is usually selected 
for the administration of medicines which are not bulky, nor of 
disagreeable taste, have no corrosive property, nor deliquesce 
rapidly on exposure. Deliquescent substances, and such as 
contain a large proportion of fixed or volatile oil, should always 
be recently pulverized, as they deteriorate when kept. Most 
substances employed in the form of powder are usually pulver- 
ized on a large scale. For the purpose of pulverizing drugs in 



PHARMACOLOGICAL REMEDIES. 5 I 

small quantity, the physician makes use of a pestle and mortar, 
the finer particles being afterward separated from the coarser by 
a sieve. In some cases, a stone slab and muller are used. Some 
powders are obtained by precipitation ; and the finer particles of 
a powder are often separated from the coarser by a process 
termed elutriation i in which the powder is diffused through 
water, the heavier portions being first allowed to subside, and 
the liquid being poured off 2 the finer particles settle separately. 
Volatile substances are often finely powdered by sublimation and 
by suddenly condensing their vapors. 

Salts of difficult pulverization are often granulated, by making 
a hot saturated solution of the salt, and filtering and stirring the 
filtered liquid until cool. Of late years, granulated effervescing 
salts have been used in imitation of the waters of mineral springs, 
the effervescence being produced by the addition of sodium bicar- 
bonate and tartaric or citric acid. 

The lighter powders may be administered in water or other 
thin liquid. The heavier powders require a more consistent 
vehicle, as syrup, or honey. 

Pills (Pilules) are small globular masses, of a semi-solid con- 
sistence, and of a size that can be conveniently swallowed. 

The form of pill is suitable for the exhibition of medicines 
which are not bulky, and are of disagreeable taste or smell, or 
insoluble in water. Deliquescent substances should not be made 
into pills, and those which are efflorescent should be previously 
deprived of their water of crystallization. 

Some substances are readily made into pills with the addition 
of a little water, spirit, glycerin, extract of gentian, or syrup. 
Very soft or liquid substances require the addition of some dry 
inert powder, as acacia, to reduce them to a proper consistence. 
Wax is a good excipient for oils. 

Heavy powders are mixed with some soft solid, as confection 
of rose, plasma, manna, etc., or with a tenacious liquid, as treacle 
or syrup. When the pilular mass is properly prepared, it is 
rolled with a spatula into a cylinder of uniform thickness, and is 
then divided into the required nufnber of pills, with the spatula, 
or, more accurately, with a pill-tile, or with a pill-machine. The 
pills are rolled into spherical form between the fingers ; and, to 
prevent adhesion, are dusted with some dry powder, as pow- 



52 MATERIA MEDICA. 

dered liquorice-root, lycopodium, orris-root, starch, or magne- 
sium carbonate. They should weigh from one to four grains, 
unless metallic, when a weight of from six to eight grains is 
admissible ; a large pill is termed a bolus. When long kept, 
pills may pass unchanged through the stomach and bowels, and 
are', therefore, objectionable. To conceal the taste and smell of 
pills, they are sometimes coated with gelatin, collodion, mucilage, 
sugar, etc. When they are designed to be of slow operation, the 
modern practice of sugar coating pills answers very well. But, 
when they are intended to act quickly, the coating is objection- 
able, as it retards the solution of the pills in the gastric fluid. 
Compressed pills are made without excipients, simply by subject- 
ing medicinal substances to pressure in moulds ; in this way, 
extraneous matter is avoided, and smaller bulk is secured. Gela- 
tin capsides are used to enclose disagreeable medicaments. 

Troches or Lozenges (Trochisci) are small, dry, solid masses, 
made of powders with sugar and mucilage, and intended to be 
held in the mouth and allowed to dissolve slowly. Mucilage of 
tragacanth is usually employed in preparing lozenges. 

Confections (Confectiones) are soft, solid preparations, made 
with some saccharine matter. They are subdivided into Con- 
serves and Electuaries : the former consist of combinations of 
recent vegetable substances and refined sugar, beat into a uni- 
form mass ; the latter are extemporaneous mixtures of medicines, 
usually dry powders, with syrup, honey or treacle. 

Papers (Chartce) are preparations designed for external appli- 
cation, which are made by spreading mixtures of medicinal sub- 
stances, as cantharides or mustard, upon paper. 

LIQUIDS. 

Mixtures {Misturce) are preparations of insoluble substances 
suspended in water by means of acacia, sugar, the yolk of eggs, 
or other viscid matter. When the suspended substance is olea- 
ginous the mixture is termed an emulsion. 

Solutions (Liquores) are solutions (chiefly aqueous) of non- 
volatile substances, which are wholly soluble in the menstruum 
employed. In making solutions, and all other aqueous prepa- 
rations, the water used should be fresh river, rain, or distilled 
water, and free from saline impurities. 



PHARMACOLOGICAL REMEDIES. 53 

Medicated Waters {Aqua) are preparations consisting of 
water holding volatile or gaseous substances in solution. They 
are best made by distilling water from plants containing volatile 
oils, and are thence termed distilled waters. In place of distilla- 
tion, trituration with magnesium carbonate (afterward separated 
by filtration) is often employed to impregnate water with vola- 
tile oils ; but the watery distillates have a more delicate fragrance 
and flavor. 

Infusions {Infusdj* are partial solutions of vegetable substances 
in water, obtained without the aid of ebullition. They are made 
with both hot and cold water ; the former extracts the soluble 
principles more rapidly and in larger proportion ; the latter is 
preferred should the active principles be injurable by heat, or if 
it be desirable not to take up some matter insoluble at a low tem- 
perature. When the process takes place at a heat of from 6o° 
to 90 it is termed maceration ; when at a heat of from 90 to 
ioo°, digestion. A more efficient mode of extracting the medi- 
cinal virtues of plants is percolation or displacement. In this opera- 
tion, the medicinal substance is coarsely powdered and placed 
in a conical or nearly cylindrical instrument called a percolator, 
in the lower part of which is fitted a porous or colander-like 
partition or diaphragm. The powder is then saturated with 
water or other menstruum till it will absorb no more ; and, after 
they have remained for some time in contact, fresh portions of 
the menstruum are added, till the required quantity is employed. 
The fresh liquid, as it is successively added, percolates the solid 
particles of the medicinal substance, driving the previously satu- 
rated liquid before it ; and in this way completely exhausts the 

* "An ordinary Infusion, the strength of which is not directed by the physician, 
nor specified by the Pharmacopoeia, shall be prepared by the following formula : — 

Take of 

The Substance, coarsely comminuted, ten parts, 10 

Boiling Water, one hundred parts, 100 

Water, a sufficient quantity. 

To make one hzmdred parts, 100 

Put the Substance into a suitable vessel, provided with a cover, pour upon it the 
Boiling Water, cover the vessel tightly, and let it stand two hours. Then strain, and 
pass enough Water through the strainer to make the Infusion weigh one hundred 
(100) parts:'— (U. S. P., 1880.) 






54 MATERIA MEDICA. 

substance to be dissolved. An ordinary glass funnel answers 
very well for percolation ; and a circular piece of muslin or lint, 
pressed into the neck by means of a cork with notched sides, 
forms a good diaphragm — care being taken to interpose a similar 
piece of muslin, moistened slightly with the menstruum, between 
the diaphragm and powder.* 

Decoctions (DecoctaX) are partial solutions of vegetable sub- 
stances in water, in which the active principles are obtained by 
ebullition. This is a more rapid and efficient mode of extract- 
ing the virtues of plants than by infusion. But. it is objection- 
able when the proximate principles are volatile at a boiling heat 
or undergo decomposition by ebullition. In making decoctions 
ebullition should be continued for a few minutes only, and the 
liquid should be allowed to cool slowly in a close vessel. As 
they are apt to spoil, they should be prepared only when 
wanted for use. 

Tinctures (Tincture?) are solutions of medicinal substances in 
alcohol or diluted alcohol. The aromatic spirit of ammonia and 
ethereal spirit are also sometimes employed as solvents ; and 
solutions in these menstrua are called ammoniated tinctures and 



* A process termed dialysis is often made use of, based upon the different diffusi- 
bility of liquids, by which mixed substances are separated from each other. For this 
purpose an apparatus termed a dialyser is employed, which consists of a circular 
glass basin, containing distilled water, in which floats a smaller vessel, the bottom of 
which is made of parchment paper, and which holds the liquid to be submitted to 
dialysis. If a watery liquid, containing both crystalloid and gelatinous matter, be 
subjected to the dialyser, it will be found that after a time a portion of the former 
will pass through the parchment and be held in solution by the distilled water of the 
larger vessel. 

f " An ordinary Decoction, the strength of which is not directed by the physician, 
nor specified by the Pharmacopoeia, shall be prepared by the following formula : — 

Take of 

The Substance, coarsely comminuted, ten parts, io 

Water, a sufficient quantity. 



To make one hundred parts, ioo 

Put the Substance into a suitable vessel, provided with a cover, pour upon it one hun- 
dred (ioo) parts of Cold Water, cover it well, and boil for fifteen minutes; then let 
it cool to about 45 C. (i 13 F.). Strain the liquid, and pass through the strainer 
enough cold water to make the product weigh one hundred (ioo) parts." — (U. S. P., 
1SS0.) 



PHARMACOLOGICAL REMEDIES. 55 

ethereal tinctures. Alcohol or rectified spirits (sp. gr. 0.820, 
U. S. P.) is employed in making tinctures of substances nearly 
or quite insoluble in water, as the resins, iodine, etc. Diluted 
alcohol or proof spirit (equal weights of Officinal alcohol and 
water) is preferred, when the substance is soluble both in alco- 
hol and water, or when some of its ingredients are soluble in 
the one menstruum and some in the other. Tinctures have 
been usually prepared by maceration or digestion, more com- 
monly by the former process, and a period of two weeks is 
recommended for its duration. It should be conducted in well- 
closed glass vessels, which should be frequently shaken ; and 
when the maceration is completed, the tincture should be sepa- 
rated from the dregs by filtration. The U. S. P. now recom- 
mends percolation in making most tinctures, and, in the hands 
of skillful pharmaceutists, this process is preferable, as the most 
thorough mode of exhausting medicinal substances ; but, where 
the operator cannot trust himself, it is better to recur to the old 
process of maceration. Tinctures should be kept in bottles 
accurately stoppered to prevent evaporation, which might seri- 
ously increase their strength. 

Tinctures of Fresh Herbs {Tincture? Herbarum Recentium). 
" These tinctures, when not otherwise directed, are to be pre- 
pared by the following formula : — 

Take of 

The Fresh Herb, bruised or crushed, fifty parts, . 50 

Alcohol, one hundred parts, loo 

Macerate the herb with the alcohol for fourteen days ; then ex- 
press the liquid and filter." (U. S. P., 1880.) 

The form of tincture is adapted to the exhibition of medicines 
whicji are to be given in small quantity, and it affords a con- 
venient mode of graduating doses. In prescribing large and 
continued doses of tinctures, the stimulating effects of the alco- 
hol which they contain must be borne in mind. 

Spirits (Spiritus) are alcoholic solutions of volatile or gaseous 
principles, properly speaking procured by distillation, but now 
usually prepared by dissolving the volatile principles in alcohol 
or diluted alcohol. The spirits of the aromatic vegetable oils 
are used to give a pleasant odor and taste to mixtures, to cor- 



$6 MATERIA MEDIC A. 

rect the nauseating and griping effects of cathartics, and also as 
carminatives and stomachics. 

Wines ( Vinci) are solutions of medicinal substances in stronger 
white wines. 

Vinegars {Acetd) are infusions or solutions of medicinal sub- 
stances in distilled vinegar or diluted acetic acid. 

Honeys {Mellitd) are preparations of medicinal substances in 
honey. 

Syrups (Syrupi) are preparations of medicinal substances in 
concentrated solutions of sugar. The term syrup (syrupus), or 
simple syrup, is applied to a solution of sugar (65 parts) in 
water (sufficient to make 100 parts of syrup), dissolved with 
the aid of heat. Medicated syrups are usually made by incor- 
porating refined sugar with vegetable infusions, decoctions, ex- 
pressed juices, fermented liquors, or simple aqueous solutions. 
They may also be prepared by adding a tincture to simple 
syrup, and afterward evaporating the alcohol ; or by mixing 
the tincture with sugar in coarse powder, and dissolving the 
impregnated sugar, after evaporation, in the necessary propor- 
tion of water. Syrups are apt to be spoiled by heat, and should 
be made in small quantities at a time. 

Fluid Extracts (Extracta Fluidd) have the advantage over 
solid extracts of convenience of administration, and of being 
prepared at a less degree of heat. In preparing them alcohol 
and glycerin are the menstrua chiefly resorted to. The por- 
tion of the solvent which remains after evaporation contributes 
in some degree to the preservation of the preparation. Accord- 
ing to the U. S. P., 1880, 1 c.c. of the fluid extract represents 1 
gm. of the drug — a decrease in strength of about 5 per cent, 
from the former standard. 

Glycerites (Glycerita) are solutions of medicinal substances 
in glycerin, made by rubbing them together in a mortar. 

The Oleo-resins (Oleoresince) are extracts obtained by the 
agency of ether, which consist of fixed or volatile oils, holding 
resins, and sometimes other active matters, in solution. They 
retain a liquid or semi-liquid state upon the evaporation of the 
menstruum employed in their preparation, and have the property 
of self-preservation. 



PHARMACOLOGICAL REMEDIES. 57 

SEMI-SOLIDS. 

Suppositories {Suppositorid) are soft solids, made by mixture 
of a medicinal substance with the oil of the,obroma, usually in 
a conical form, of a weight of 1 5 grains, and designed for in- 
troduction into the rectum. They are employed with a view 
both to a local effect on the lower bowel and also to the gradual 
absorption of the medicinal substance. As absorption from the 
rectum is slow, larger quantities are required than by the 
mouth. 

Extracts (Extracta). — By the evaporation of the solutions of 
vegetable principles a very useful class of preparations, termed 
Extracts, is obtained. They are prepared from infusions, de- 
coctions, tinctures and vinegars, and sometimes, in the case 
of recent vegetables, from the expressed juices of plants, usually 
diluted with water. Extracts prepared by the agency of water 
are termed watery extracts ; those by means of alcohol, alcoholic 
extracts; those by means of acetic acid, acetic extracts. The 
evaporation of extracts is generally continued till they have a 
pilular consistence. 

Liniments (Linimentd) are oily preparations designed for 
external use, usually thicker than water, but always liquid at 
the temperature of the body. 

Ointments (Unguenta) are preparations of a consistence like 
that of butter, made with lard or some other fatty substance. 
They are fitted for application to the skin by friction or inunc- 
tion. Most of the ointments become rancid when long kept, 
and it is therefore best to prepare them only as wanted for use. 
Petrolatum, a substitute for vaseline, a straw-colored ointment 
made from petroleum, not decomposable, is a superior unguent 
for general purposes. The term ointment {tcnguentum) is applied 
to a mixture of 20 parts of yellow wax and 80 parts of lard. 

Cerates (Cerata) are made of oil or lard, mixed with wax, 
spermaceti or resin, with the addition of various medicinal sub- 
stances. They are of harder consistence than ointments, and 
do not melt when applied to the skin. The term cerate (ceratum) 
is applied to a mixture of 30 parts of white wax and 70 parts of 
lard. 

Oleates {Oleata) are made by combining oleic acid with 
metallic bases or alkaloids. The combination is effected by 



58 MATERIA MEDICA. 

rubbing them together in a mortar, and is generally aided by 
heat. 

Plasters (Emplastrd) are adhesive at the temperature of the 
body, and must generally be heated to be spread. Some sub- 
stances have sufficient consistence and adhesiveness to be made 
into plasters. Usually, however, medicinal substances, when 
employed in this form, are mixed with Lead Plaster or Litharge 
Plaster (Emplastrum Plumbi), a compound of olive oil and 
litharge. Plasters are prepared for use by spreading them 
upon sheepskin, linen or muslin, with a margin a quarter- or 
half-inch broad. 

Cataplasms or Poultices {Cataplasmatd) are soft, moist 
substances intended for external use. The common emollient 
poultice, employed to relieve inflammation and to promote sup- 
puration, is made by mixing bread-crumbs with boiling milk 
or powdered flaxseed with boiling water. A fabric termed 
spongiopiline, consisting principally of sponge, has been used as 
a substitute for the old poultice, and, when saturated with hot 
water, is a good vehicle of heat and moisture. 

GASES AND VAPORS. 

When employed in this form medicines are administered by 
inhalation. This may be effected either by diffusing the gas 
or vapor through the air to be respired by the patient ; or by 
inclosing it in a bag or bottle with a suitable tube, through 
which the patient may breathe ; or, when ethereal vapors are 
employed, by saturating a sponge or handkerchief with the 
ether and applying it to the mouth and nostrils of the patient ; 
or the fumes of burning medicinal substances may be inhaled 
by means of cigarettes or pipes variously contrived. 

WEIGHTS AND MEASURES. 

In prescribing and dispensing medicines the following are 
the weights and measures employed in the United States, with 
their signs annexed : — 

TROY OR APOTHECARIES' WEIGHT. 

The pound, lb ] f Twelve ounces, ^ . 

The ounce Eight drachms, 3 . 

The drachm contains \ Three scruples, £) . 

The scruple Twenty grains, gr. 



PHARMACOLOGICAL REMEDIES. 59 

The term powtd should be avoided in formulae, owing to the 
danger of mistakes from confounding the Troy pound with the 
heavier avoirdupois pound, and large weights should be ex- 
pressed in Troy ounces. The scruple sign (3) should not be 
used in prescribing, because of the liability of mistaking it for 
the drachm (5). All weights of less than a drachm should be 
expressed in grains (gr.). The Troy ounce contains 480 grains ; 
the drachm, 60 grains. 

In France and other parts of the continent of Europe a sys- 
tem of metrical weights is employed, which system has for its 
unit the meter (39.37 inches), which is the ten-millionth part of 
the distance from the pole to the equator measured on any 
meridian. From this basis all other weights and measures are 
calculated. As all the divisions are obtained from the multiple 
ten, it is purely a decimal system. The names given to the dif- 
ferent multiples and divisions of the unit are indicated by prefixes 
derived from the Latin and Greek. 

FOR SUBDIVISION. 

f Milli indicates the T7 Vj ^ of the unit. 
Latin. ) Centi " " yfo " " 

IDeci " " T L " « 

FOR MULTIPLICATION. 

Deca indicates 10 times the unit. 

Hecto " 100 " " 

Greek, j k[]q tt iqqq (( 

1 Myria " 10,000 " " 

In the metric system fluids as well as solids are expressed by 
weight, consequently the gram (unit of weight) and its decimal 
divisions enter only into the calculation of a prescription. A 
gram is the weight of a cubic centimeter of water at 4 C. The 
subdivisions of the gram are milligram, centigram and decigram ; 
the multiplications, decagram, hectogram, etc. Instead of using 
the latter terms the total is better expressed in grams. The 
sign Gm. is used to denote gram, c. c, cubic centimeter, and to 
denote quantity, Arabic figures ; the latter should precede the 
symbol. In prescribing liquids, allowance must be made for 
the relation existing between sp. gr. and bulk. In each case, of 
spirits, tinctures and oils -^ less, of stronger ether \ less, of 






6o 



MATERIA MEDICA. 



spirit of nitrous ether -J- less, of glycerin \ more, of syrup J 
more, of chloroform \ more, must be ordered. In the case of 
spirits and tinctures the difference is so slight that it may be 
disregarded. Rules for expressing quantity by weight of the 
Troy system in metric terms : A. Reduce the quantity to grains 
and divide by 1 5 ; the quotient expresses the quantity in grams 
(nearly). B. Reduce each quantity to drachms and multiply 
the number by 4 ; the product is the number of grams repre- 
senting nearly the same quantity. These rules are to be em- 
ployed in changing fluid measures to grams. In round num- 
bers 1 f§ = 31 c. c. ; 1 c. c. or Gm. = gr. i$}4 of distilled 
water. It has been suggested to use the term flui-gram for c. c. 
(Mann and Oldberg.) 



Comparative Table of Decimal with Troy Weights. 



Names. 


Equivalent in Grams. 


Equivalent in Grains. 


Equivalent in Troy 
Weight. 


Milligram 


.OOI 
.OI 

IO 

IOO 

IOOO 

I OOOO 


.OI54 

•1543 

1-5434 

I5-4340 

154.3402 

1543.4023 

15434.0234 

154340.2344 


6T 
1 

6 

i-5 

15-4 

2 34.0 

3 1 43-o 

28 1 14. 
26 9 4 20. 


Centigram 

Decigram 

Gram 


Decagram 


Hectogram 

Kilogram 


Myriagram 



The gallon, C. 
The pint 
The fluidounce 
The fluidrachm 



WINE OR APOTHECARIES' MEASURE. 



contains 



Eight pints, O. 
Sixteen fluidounces, f ^ 
Eight fluidrachms, f 3 . 
[ Sixty minims, Tr^. 



The term gallon is not used by the U. S. Pharmacopoeia, that 
measure being always expressed in pints. 

Liquid measures are sometimes prescribed by drops, which, 
however, vary in quantity according to the nature of the liquid, 
the shape and size of the vessel from which they are dropped, and 
even the amount of liquid which the vessel contains. (Thus, a 
fluidrachm of distilled water contains only 45 drops, while this 



PHARMACOLOGICAL REMEDIES. 



6l 



measure of alcohol and of most tinctures contains 120 drops, 
and of chloroform 220 drops, or even more.) Approximate 
measurements are also frequently employed^ in prescribing the 
less powerful liquids : thus a teacup is used for f^iv, or a gill ; a 
wineglass for f gij ; a tablespoon for f 5ss ; a teaspoon for f 3j ; as 
these are uncertain, a graduated measure is preferable. 

Table for Converting Cubic Centimeters into Fluidrachms. 



Cubic Centimeters. 


0. 


1. 


2 


3. 


4. 


5. 


6. 


7. 


8. 


9. 




dr. m. 


dr. m. 


dr. m. 


dr. m. 


dr. m. 


dr. m. 


dr. m. 


dr. m. 


dr. m. 


dr. m. 


O 


O 


O l6 


032 


O49 


15 


I 21 


137 


153 


2 IO 


2 26 


IO 


242 


258 


3 15 


331 


3 47 


43 


4 19 


4 3 6 


4 52 


58 


20 


5 24 


5 41 


5 57 


6 13 


6 29 


646 


72 


718 


7 34 


751 


30 


87 


823 


8 39 


856 


9 12 


928 


9 44 


10 


10 17 


I0 33 


40 


I049 


115 


11 22 


II 38 


11 54 


12 10 


12 27 


1243 


1259 


13 15 


50 


1331 


13 48 


144 


I420 


1436 


14 53 


159 


1525 


15 4i 


15 58 


60 


l6 14 


1630 


1646 


17 2 


17 19 


17 35 


I75i 


187 


1824 


1840 


70 


1856 


19 12 


1928 


I944 


20 1 


20 17 


2034 


20 50 


21 6 


21 22 


80 


2138 


2155 


22 11 


22 27 


2243 


23 


23 16 


2332 


23 48 


24 4 


90 


24 20 


24 37 


24 53 


25 9 


25 26 


2542 


2558 


26 14 


2631 


2647 



100 cubic centimeters are equal to 27 fluidrachms 3 minims, or 3 fluidounces 3 
fluidrachms and 3 minims. 



A variety of circumstances, relating to the human organism, 
modify the effects of medicines. 

Age exerts a most important influence in this particular. 
Children are more susceptible than adults ; and in advanced age, 
also, smaller doses are required than in the prime of life. No 
general rule can be laid down for the adaptation of the doses of 
medicine to different ages, as the susceptibilities to the influence 
of different medicines are unequal at the same age. Thus, 
infants are peculiarly alive to impressions from opium, while in 
the cases of calomel and castor oil, they will bear much larger 
proportional doses. 

Dr. Young's scheme for graduating the doses of medicines to 
different ages answers very well in prescribing : For children 
under twelve years, the doses of most medicines must be dimin- 
ished in the proportion of the age to the age increased by 12 ; 
thus, at two years to \, viz.: —^ = ■}-. At 21 the full dose may 
be given. 



62 



MATERIA MEDICA. 



MaiscWs Table for Converting Apothecaries' Weights and Meas- 
ures i?tto Gram Weights. 









Grams for Liquids. 


Troy Weight. 


Grams. 


Apothecaries' 


















Measures. 














Lighter 


Spec. Grav. 


Heavier 








than Water. 


of Water. 


than Water. 


Grain ^ 


.004 


Minim 1 


.055 


.06 


.08 


T2 


.005 


2 


.IO 


.12 


•15 




.006 


3 


.16 


.18 


..24 


1 


008 


4 


.22 


.24 


•32 


* 


.OIO 


5 


.28 


•3 


.40 


l 


.016 


6 


•32 


.36 


.48 


1 


.02 


7 


•38 


.42 


•55 


\ 


•03 


8 


•45 


• -5 


.65 


f 


•05 


9 


•50 


•55 


•73 


I 


.07 


10 


•55 


.6 


.80 


2 


•13 


12 


.65 


.72 


.96 


3 


.20 


14 


.76 


.85 


1. 12 


4 


.26 


15 


.80 


•9 


1.20 


5 


•32 


16 


.90 


1.0 


1.32 


6 


•39 


20 


1. 12 


1.25 


1.60 


7 


•45 


25 


1.40 


i-55 


2.00 


8 


•52 


30 


1.70 


1.90 


2.50 


9 


•59 


35 


2.00 


2.20 


2.90 


io'Oss) 


.65 


40 


2.25 


2.50 


3-3° 


12 


.78 


48 


2.70 


3-o 


4.00 


14 


.90 


5o 


2.80 


3.12 


4-15 


15 


1. 00 


60 (f 3 j) 


3-40 


3-75 


5.00 


16 


1.05 


65 


3.60 


4.0 


5-30 


18 


1. 18 


72 


4-o5 


4-5 


6.00 


20(BJ) 


'•3 


80 


4-5° 


5-o 


6.65 


24 


1 5 


90 (f 3 iss) 


5-i° 


5-6 


7-5o 


30 ( 3 ss) 


i-95 


96 ' 


540 


6.0 


800 


32 


2.1 


IOO 


5.60 


6.25 


8.30 


36 


2.2 


I20(f£ij) 


6-75 


7-5 


10.00 


4o(9ij) 


2.6 


i5o(f3iiss) 


8.50 


9-5 . 


12.50 


45 


3-o 


160 


9.00 


10.0 


13-3° 


5°O iiss ) 


3-2 


i8o(f3iij) 


10.10 


IT. 25 


15.00 


60 (5j) 


3-9 


210 (f ^ iiiss) 


11.80 


I3.O 


17.50 


70 


4-55 


240 (fgiv) 


1350 


I5.O 


20.00 


8o(9iv) 


5-2 


f 3 v 


16.90 


18.75 


25.00 


90. ( 3 iss) 


5-9 


f 3 vss 


18.60 


20.75 


27.50 


IOO ( i^v) 


6.5 


f 3vj 


20.25 


22.5 


30.00' 


no (9 vss) 


7-i 


f3vij 


23.60 


26.25 


35-o° 


120 ("3 ij) 


7.80 


f.^viij (fgj) 


27.00 


30.0 


40.00 


150 (3iiss) 


9 75 


fgix 


3040 


33-75 


45.00 


180 (ziij) 


11.65 


fjjx 


33-75 


37-5 


50.00 


240 ( ^ ss) 


15-5 


f k x ii ( f 3 iss ) 


40.50 


45° 


60.00 


300 ( 3 v) 


19.4 


f 3 xiv 


47-25 


52.5 


70.00 


360 (3vj) 


23-3 


fjlij 


54.00 


60.0 


80.00 


420 (3vij) 


27.2 


f^iiss 


67.50 


75-o 


100.00 


480 (gj) 


311 


fgiij 


81.00 


90.0 


120.00 


§ij 


62.2 


f 2; iiiss 


94-5° 


105 


140.00 


fiv 


124.4 


f'giv 


108.00 


120.0 


160.00 



PHARMACOLOGICAL REMEDIES. 63 

A good practical rule for graduating doses is that of Dr. Cow- 
ling : " The proportional dose for any age under adult life is 
represented by the number of the following birthday divided by 
twenty-four : " for one year -^ = -^ ; for three years, -fe — \ ; for 
eleven years, \\ = \. 

Sex, temperament, and idiosyncrasy, all modify the effects of 
medicines. Women require somewhat smaller doses than men ; 
and during menstruation, pregnancy, and lactation, all active 
treatment which is not imperatively demanded should be avoided. 
To persons of a sanguine temperament, stimulants are to be 
administered with caution, while, in cases of the nervous tem- 
perament, the same care is to be observed in the employ- 
ment of evacuants. Mercurials are called for where the bilious 
temperament exists, but, on the other hand, they are generally 
injurious where the lymphatic temperament is strongly marked. 
Idiosyncrasy renders many individuals peculiarly susceptible or 
insusceptible of the action of particular medicines, as mercury, 
opium, etc. 

In disease, an extraordinary tolerance of the action of many 
medicines is established. In tetanus, immense quantities of 
opium are borne and required ; in typhoid fever, alcohol is freely 
administered without inducing intoxication ; in pneumonia, tar- 
tar emetic may be taken in large doses without nausea. 

The time of administration modifies the action of medicines. 
Where a rapid effect is desired, they are to be given on an empty 
stomach ; on the other hand, irritant substances, as the arsenical 
or iodic preparations, are best borne when the stomach is full ; 
and the insoluble chalybeates, requiring the gastric fluid to dis- 
solve them, should be taken with the food. To counteract the 
collapse of low fevers, stimulants, in the early morning hours, are 
called for. 

The co7tdition of the stomach is to be considered in prescribing 
medicines. In the black vomit of yellow fever absorption cannot 
take place by the stomach, and in the second stage of cholera 
endosmosis by the bowels is impossible ; here, the hypodermic 
medication is invaluable. 

Habit diminishes the influence of many medicines, especially 
narcotics. 

The influence of race, climate, occupation, and the imagination, 



64 MATERIA MEDICA. 

upon the effects of medicines is often decided, and deserves 
attention in prescribing. 

PARTS TO WHICH MEDICINES ARE APPLIED. 

Medicines are applied to the skin, to mucous membranes, to 
serous membranes, to wounds, ulcers, cysts, and abscesses, and 
they are injected into the veins. 

1. To the Skin. — Medicines are applied to the skin for both a 
local and a general effect ; when brought in contact with the 
skin without friction it is termed the enepidermic method. As 
their influence on distant organs is the result of their absorption, 
this function must be taken into consideration. Solutions of 
medicinal substances in water permeate slowly through the skin 
to enter the vessels. M. Hebert first drew attention to the fact 
that the oily secretion of the sebaceous follicles of the skin pre- 
vented the contact of aqueous liquids with the cuticle, but the 
cuticle itself is the main impediment to absorption. Waller* 
found that chloroformic solutions of the alkaloids placed in con- 
tact with the skin readily produced their effects upon the system. 
He ascertained that chloroform quickly osmoses through the 
skin, carrying with it dissolved substances, and that the rationale 
of the process was not due to a solvent action on sebaceous 
matter. 

The application of medicines to the skin by friction, the epi- 
dermic method, is occasionally resorted to, but its results are slow 
and uncertain. When we wish to affect the system through 
the agency of the skin, the preferable method is to apply the 
medicine to the dermis denuded of the cuticle. This is termed 
the endermic method, and the cuticle is usually removed by means 
of a blister. The medicine is applied to the denuded dermis in 
the form of powder, or, if very irritating, it may be incorporated 
with gelatin, lard, or cerate. This method is useful in cases of 
irritability of the stomach, of inability to swallow, or where we 
desire to influence the system rapidly and by every possible 
avenue, or where it is of importance to apply the medicine near 
the seat of the disease. The dose is to be two or three times the 
amount which is administered by the stomach. Inunctions of 

* The Practitioner, London, 1 869, vol. iii, p. 330. 



PHARMACOLOGICAL REMEDIES. 65 

oil, when the digestive apparatus is unequal to its absorption, 
are sometimes of service in asthenic conditions. The skin should 
be washed with soap and water first. 

Another means of applying medicines through the skin is by 
injection into the subcutaneous cellular tissue, and is termed the 
hypodermic method. Medicines are injected hypodermically for 
both a local and a general effect. A constitutional impression 
can be produced by this means more certainly, rapidly, and effi- 
ciently than by the introduction of medicines into the stomach. 
It is particularly adapted to the speedy relief of pain, to the 
treatment of diseases in which it is desirable to influence the 
system with the greatest possible rapidity and effect, and also to 
cases where the internal administration of medicines is interfered 
with. The substances proper for hypodermic injection are those 
which are small in bulk and are of perfect solubility, such as 
the alkaloids. Substances of imperfect solubility should not be 
injected hypodermically, dangerous results having followed 
therefrom, as from the use of the salts of quinine. The dose, par- 
ticularly in first injections, should be two-thirds of the ordinary 
dose by the stomach, and for females about one-half. 

The instrument used for injection is a small syringe armed 
with a sharp tubular needle, and, for the better regulation of the 
dose, it is desirable that the syringe should be graduated. It is 
important to avoid the puncture of a vein, lest a suddenly over- 
whelming effect be produced ; and, with this view, the syringe- 
needle should not be pushed too deeply into the tissues, and 
should be withdrawn a little to allow a wound of a vein to close 
from elasticity. When a constitutional effect only is aimed at, 
non-sensitive, vascular parts should be selected, in order to 
facilitate absorption and give little pain, such as the waist ; 
another good spot for injection is at the insertion of the deltoid 
muscle, or in the radial border of the forearm, and, where re- 
peated operations are practiced, it is well to vary the point of 
injection. Irritating injections are best tolerated in the back. 
To preserve hypodermic solutions from the destructive action 
of a low order of vegetation (algae), cherry laurel-water or a weak 
borax solution should be used. 

2. To Mucous Membranes. — Medicines are applied to all the 
gastro-pulmonary and genito-urinary mucous surfaces. 
5 



66 MATERIA MEDICA. 

a. To the conjunctiva they are applied for local effects only, 
and are termed collyria, or eye-washes. Their strength should 
be weak when first used. 

b. To the nasal or pituitary membrane, they are applied usually 
for local purposes ; sometimes, however, to irritate and excite a 
discharge, when they are termed errhines ; sometimes, also, to 
produce sneezing, with a view to the expulsion of foreign bodies 
from the nasal cavities, when they are termed sternutatories. 

c. To the mucous membrane of the mouth and throat, medicines 
are applied almost exclusively for local purposes. When in 
solution, they are termed gargarismata or gargles. Powders are 
introduced by insufflation, as by a scoop-insufflator. 

d. To the Eustachian tubes, washes are applied in local affec- 
tions. 

e. On the aerial or tracheo- bronchial membrane, medicines pro- 
duce a very decided influence, both local and general. Liquid 
substances are introduced into the air passages by means of a 
sponge or syringe, in the treatment of chronic inflammations of 
the larynx. This kind of instrumentation should be preceded 
by spraying the part with cocaine. Various substances are in- 
haled with advantage in phthisis, chronic bronchitis and laryn- 
gitis, asthma, etc., while the most powerful effects are produced 
on the system by the absorption of ethereal vapors and gases 
through the pulmonary surface. 

Within the last few years, liquids have been introduced into 
the air passages for the treatment of diseases of the respiratory 
organs, in the form of a fine spray. This mode of application, 
termed the atomization of fluids, has proved very valuable, par- 
ticularly in the relief of throat affections. Various instruments 
have been resorted to in the atomization of liquids. The hand- 
ball atomizer, which is usually employed, consists of two glass 
tubes, with capillary openings, placed at right angles to each 
other, the vertical tube being dipped in a bottle containing the 
fluid to be atomized, while at the other end it is close to and 
about opposite to the centre of a capillary opening in the hori- 
zontal tube. This connects with an elastic tube, intercepted by 
two elastic balls, one in the middle, the other, which is furnished 
with valves, at the end of the tube. The upper ball acts as a 
reservoir, into which a current of air is forced from the lower 



PHARMACOLOGICAL REMEDIES. 6j 

ball by pressure with the hand. The air in the vertical glass 
tube being rarefied, the liquid rises to the capillary opening, and 
is there pulverized by the current of air from the horizontal tube. 
In Snowden's atomizer there is but one tube through which the 
fluid is forced and broken into a fine spray at the tip. To Sajous' 
pharyngeal atomizer there is a tongue-depressor attached, so 
that the patient can use it without assistance. 

Irritating substances should be guardedly applied to the 
upper air passages, and especially so is this the case with the 
larynx, and before active treatment is instituted the membrane 



Fig. 2. 




THE HAND-BALL ATOMIZER. 



should be cleansed, for which purpose there is nothing better 
than to spray the parts with Dobell's solution.* 

Other medicaments well adapted to atomization are zinc 
sulph. gr. iij-v to aq. foj ; tannin gr. v ; borax ; boracic acid ; 
silver nitrate, potassium permanganate, etc. The atomizer is 
used also to produce local anaesthesia, and as a deodorizer. 



k R Acidi carbolici liquidi, TTLxxx 

Sodii biboratis, 

Sodii bicarbonatis, ....... aa gj 

Glycerini, . ' f^iiiss 

Aquae, ad f! iv - M- 

Sig. — To be used in atomizer. 



68 MATERIA MEDICA. 

As modified by Sass, by means of differently shaped tubes, the 
spray can be readily generated within various parts of the body, 
as the back of the throat, nostrils, meatus of the ear, etc. In- 
stead of air, steam has been substituted as the forcing power in 
the apparatus known as Siegle's. In this instrument inhalation 



Fig. 3. 



^ 



SASS SPRAY TUBES. 



can be practiced without fatigue or assistance, and the warmth 
of the spray is also an advantage in^many diseases of the respira- 
tory organs. The volatile oils, camphor, and potassium chlorate 
are suitable for steam atomization. 

f. The gastro-intestinal mucous membrane, of all parts of the 
body, is most employed for the exhibition of medicines. The 
stomach, from its great vascularity, its solvent secretions, and 
the numerous relations which it has with almost every part of 
the body, is the chief recipient of medicinal agents. The rectum 
is, however, also frequently employed for various purposes, as 
to relieve disease of this or of neighboring organs, to occasion 
revulsion, to produce alvine evacuations, to destroy ascarides, 
and when, for any reason, it is desirable to spare the stomach. 

It is usually recommended that the dose of medicines intro- 
duced into the rectum for constitutional effects should be two or 
three times greater than when taken into the stomach. In the 
case of active, soluble medicines, however, especially narcotics, 
it is most prudent to give the same amount by the rectum as by 
the mouth. 

Solid substances introduced into the rectum are termed sup- 
positories. Liquids introduced into the rectum are termed clysters, 
lavements, injections, and enemata. Soluble substances, when 
thus applied, are usually dissolved in water ; insoluble substances 
are suspended in some mucilaginous vehicle. When the enema 
is to be retained, it should not exceed fgiij in quantity. When 
it is introduced to act upon the bowels, its bulk may be from 



• PHARMACOLOGICAL REMEDIES. 69 

f §xij-xvj for an adult, f Syj-viij for a youth of twelve, f §iij— iv 
for a child of one to five years, and f §j for a newly-born infant. 
Various syringes are used for the administration of enemata, 
Higginson's being among the best. Gaseous matters have also 
been thrown into the rectum, tobacco smoke, for example, to 
relieve obstruction of the bowels. As the rectum is not a digest- 
ive tube, when food is to be introduced by this channel, the 
essentials for the carrying on artificially of this process must be 
added; viz., to beef tea §iv add hydrochloric acid n#x, and gly- 
cerole of pepsin 5ij ; defibrinated blood, too, as a restorative 
agent, has been injected into the rectum after uterine hemor- 
rhage, with success (Leon).* 

g. To the urino-genital and vagino-uterine membranes, applica- 
tions are made exclusively for local purposes. Within a few 
years intra-uterine medication has been a good deal employed 
in local affections of the uterus, but in the injection of fluids into 
the uterus there is danger of metro-peritonitis. 

3. To Serous Membranes. Irritating solutions are injected 
into the cavity of the tunica vaginalis testis, in hydrocele ; into 
the hernial sac, in hernia ; and even into the pleural cavity, in 
pleurisy, for the purpose of producing adhesion of the sides of 
the sacs. 

4. To Ulcers, Wounds and Abscesses, medicines are applied 
chiefly for their local effects. The absorbing power of these 
surfaces is to be kept in mind in such applications. Cysts are 
sometimes cured by injections, as of tincture of iodine into cysts 
of the thyroid gland. 

5. The injection of medicines into the Veins has been occasion- 
ally practiced. The operation is, however, objectionable, from 
the danger of introducing air into the circulation ; and it is 
seldom resorted to, except in the case of transfusion of blood 
after uterine or other hemorrhage, or exhausting disease. 

Transfusion will often be found an efficient remedy, although 
there is always risk of coagulation of the blood in the veins. 
The more direct and immediate the transfusion, the safer the 
operation, as by Aveling's apparatus, which consists of an India- 



* Valor Terapeutico de Los Enemas de Savgre Deofribinata ; Gac. Med. Cat. 
1886, ix, 711. 



yo MATERIA MEDICA. » 

rubber bulb, oblong in shape, and of sufficient size to contain 
two fluidrachms ; India-rubber tubes six or seven inches in 
length attached to the extremities of the bulb ; and stop-cocks 
attached to the outer extremities of the tubes. Also, two silver 
tubes ; one, bevel-pointed, called the afferent tube (seen at A), 



Fig. 4. 




which is to be inserted into the vein in the arm of the patient ; 
the other, round-pointed, called the efferent tube (seen at B), 
which is to be inserted into the vein in the arm of the donor, 
also a pair of fine forceps and a scalpel.* 

THE CLASSIFICATION OF MEDICINES. 

In treating the articles of the Materia Medica some writers 
have classified them according to their natural properties, others 

* The mode of operation is as follows : — 

First, place the apparatus in a basin of tepid water, and, while completely under 
the water, for the purpose of filling it and insuring its cleanliness, compress and 
expand the bulb until the air contained within the bulb and rubber tubing is com- 
pletely expelled. When the air has been completely expelled, and while the appa- 
ratus is yet remaining beneath the surface of the water, turn the stop-cocks at both 
extremities of the rubber tubing in such a manner as to entirely preclude the possi- 
bility of air gaining access to its cavity. The patient having been brought to the side 
of the bed and the arm made bare, a fold of skin over a vein at the bend of the arm 
is to be raised, transfixed and divided. The vein now brought into view is to be 
seized with the fine forceps, slightly raised, and a small opening made into it for the 
reception of the bevel-pointed silver or afferent tube. This tube, which has been 
lying in the basin of tepid water, should carefully be kept filled with water when it 
is removed, by placing the thumb or finger over its larger opening. 

The tube, now being filled with water, has its bevel- pointed extremity at once 
inserted into the opening already made in the vein, and is then entrusted to the care 



PHARMACOLOGICAL REMEDIES. 7 I 

according to their action on the human system. To the student 
of medicine a classification based upon the sensible qualities or 
natural affinities of medicines can be of little value, since it asso- 
ciates articles of the most opposite remedial properties. A classi- 
fication of medicines founded on a similarity of action on the 
animal economy is more desirable and useful, and various 
arrangements of the Materia Medica have been attempted on 
this basis. They are all, to some extent, necessarily imperfect, 
owing partly to the diversified effects of medicines and partly to 
our ignorance of the real nature of many of the modifications 
which they produce upon the tissues. Still, the advantages of 
some arrangement of this kind are so numerous that it cannot 
well be dispensed with. 

The following classification will be found to include the more 
ordinary and generally received divisions of the Materia Medica, 
and to present the articles in convenient groups for therapeutic 
application. 



of an assistant (A), who carefully compresses the edges of the wound around the tube, 
and at the same time holds his thumb or finger over its larger opening to prevent the 
escape of the water. 

While the operator is performing this part of the operation, an assistant should pre 
pare the arm of the blood-donor in the same manner as for venesection. An open- 
ing is then made into the vein, and the round pointed or efferent tube at once inserted 
with its point toward the fingers. The donor should then be seated in a chair at the 
bedside of the patient. It is better not to secure the tubes in the veins by ligatures. 
B represents the hand of an assistant holding the efferent tube carefully compressed 
within the lips of the wound, in the same manner as with the afferent tube at A. 

The India-rubber portion of the apparatus, thoroughly cleansed, air perfectly 
expelled and completely filled with water, is now to be carefully and closely adjusted 
to the two tubes in the veins. When adjusted the stop-cocks are turned straight, and 
transfusion is commenced by first compressing the India-rubber tube on the efferent 
side (donor's), and then squeezing the bulb, which forces two drachms of water into 
the efferent vein. Next, while the bulb is compressed, shift the hand and compress 
the India-rubber tube upon the afferent (patient's) side. Then allow the bulb to 
expand slowly, and blood will be drawn into it from the donor's vein. When the 
tubing and bulbs are filled bring the hand back, compress the tube, follow this by 
compression of the bulb, and two drachms of blood will be thrown into the afferent 
vein. In this manner the process can be repeated any number of times desired, rap- 
idly or slowly, and the exact amount of blood transfused can be known by counting 
the number of times the bulb has been emptied, one being subtracted, which accounts 
for water first used. 



72 



MATERIA MEDICA NEUROTICS. 



Medicines may be divided into — 



I. Those which have a special action on the nervous 
system, or Neurotics (from vevpov, a nerve). 



II. Those which have a special action on the secretions, 
or Eccritics (from 'iiacpiGiQ, secretion). 



III. Those which modify the blood, or Hcematics (from 
alfia, the blood). 



IV. Those which act topically. 



Narcotics, 

Anaesthetics, 

Antispasmodics, 

Tonics, 

Astringents, 

Stimulants, 

Sedatives, 

Spinants. 

" Emetics, 
Cathartics, 
Diaphoretics, 
Diuretics, 
Blennorrhetics, 
Emmenagogues. 

f Hsematinics, 
"I Alteratives, 

[ Antacids. 
Antiseptics, 
Irritants, 
Demulcents, 
Coloring Agents, 

. Anthelmintics. 



CLASS I.— NEUROTICS. 



ORDER I. NARCOTICS. 

apx6a>, to stupefy) are medicines which impair 



Narcotics (from 

or destroy nervous action. The primary effect of narcotics is, 
however, of a stimulant character, and their therapeutic efficacy 
is in a great degree due to this action. They are often adminis- 
tered, too, for a true narcotic or sedative influence on the motor, 
sensory and intellectual functions. In diseased conditions, a 
marked tolerance of this class of medicines is established, and 
they can be exhibited in large doses without inducing narcosis. 
They are employed, chiefly, to remove muscular spasm, relieve 
pain, allay cerebral or spinal irritability and procure sleep. 

When employed to relieve pain, they are termed anodynes ; 
when employed to procure sleep, hypnotics or soporifics. 

When this class of medicines is resorted to for any length of 
time, with a view to a narcotic effect, their influence upon the 
system is much diminished, and constantly increased amounts 
are called for to maintain the same effect. 



NARCOTICS — OPIUM. 73 

OPIUM. 

Opium (from Wo?, juice) is the concrete milky exudation of 
the unripe capsules of Papaver somniferum (Nat. Ord. Papa- 
veraceae). The opium-poppy is a native of Persia, but is culti- 
vated in various parts of Asia, in Europe, and in the United 
States. It is an annual plant, with a round, leafy stem, from 
two to four feet or more in height, and large four-petaled flowers. 
There are two prominent varieties of this species: the black 
poppy, with violet-colored or red flowers, brown or blackish 
seeds, and globular capsules ; and the white poppy, with white 
flowers and seeds, and ovate capsules ; but these varieties run 
into each other under cultivation. 

The nearly ripe capsules (papaver) are from an inch and a 



Fig. 5. 




POPPY-CAPSULE. 



half to two inches or more in diameter, and contain a good deal 
of opium. They are sometimes given to children in the form of 
syrup, and are applied externally as an anodyne emollient, in the 
form of decoction. The seeds are destitute of narcotic properties, 
and are used in Europe as an article of diet, and for the manu- 
facture of an oil. 

Opium is obtained from incisions in the half-ripe capsules. 
The juice which exudes from the incisions is allowed to evapo- 
rate spontaneously, and is scraped off after drying, generally 
with more or less of the epidermis, and is sometimes sent into 
the market unmixed, as a choice variety. The opium of com- 
merce is, however, commonly made by adding the dried juice, 
obtained by incision, to an extract prepared by expression, or 



74 MATERIA MEDICA NEUROTICS. 

even from a decoction of the leaves, the whole being kneaded 
together, formed into cakes, and wrapped in fresh poppy-leaves. 

The commerce of the United States is supplied with opium 
almost exclusively from Asiatic Turkey. This is known in the 
market as Smyrna or Turkey opium, and comes in irregularly 
rounded or flattened cakes, covered with the capsules of a 
species of Rumex. 

A large amount of opium is produced in British India, for 
consumption in India and China, but it is not found in our mar- 
kets. The Persian opium is another variety, as is that obtained 
from upper Egypt, but these do not reach the United States. 

The best opium should have a fine chestnut color, an 
aromatic, strong, peculiar smell and a dense consistence — be- 
coming, however, harder and darker by being kept. It should 
be moderately ductile, break with a deeply-notched fracture, and, 
when drawn across white paper, should leave an interrupted 
stain. The taste is very bitter and somewhat acrid, and when 
chewed it excites irritation in the mouth and throat. It is in- 
flammable, and imparts its virtues to water, alcohol and diluted 
acids, but not to ether. 

Chemical Constituents. — Opium contains a great variety of 
chemical constituents, the most important of which is the alka- 
loid Morphina {morphine). Other principles found in opium are 
the alkaloids, narcotine, codeine, narceine, paramorphine (thebaine), 
papaverine, pseudomorphine (phormine) ; meconin, meconic and 
thebolactic acids, gum, extractive, resin, oil, etc., but no tannin or 
starch, and, in very minute amounts, alkaloids, termed meconi- 
dine, laudamine, codamine, lanthopine, rhceadine, laudanosine, 
protopine, hydrocotarnine, deuteropine, oxynarcotine, gnosco- 
pine, and cryptopine. Porphyroxin, so called by Merck, is not 
a proximate principle, but a complex substance, consisting of 
several alkaloids (Hesse). Morphine is the principle upon which 
the narcotic effects of opium essentially depend, and, with its 
salts, is officinal in all the pharmacopoeias. 

Morphine exists in opium chiefly in combination with me- 
conic acid. The morphine meconate is separated from the other 
constituents of the drug by successive macerations with water. 
Alcohol and water of ammonia are then added to the aqueous 
solution, by which the salt is decomposed, the ammonia precipi- 



NARCOTICS OPIUM. 75 

tating the morphine and the alcohol seizing the coloring matter 
as soon as it is separated from the alkali. The crystals of 
morphine which are formed are afterward boiled in alcohol, and 
the solution is filtered through animal charcoal. Good samples 
of opium, when dried, should yield not less than 12 nor more than 
16 per cent, of morphine. 

Morphina (Morphine} (Ci 7 H 19 N03.H 2 0) occurs in colorless, 
rhombic, prismatic crystals, without smell, but of very bitter 
taste. It is very slightly soluble in water and ether, nearly in-* 
soluble in chloroform, partially soluble in cold and more soluble 
in boiling alcohol. Acetic ether (ethyl acetate) is the best 
solvent for it. From the insolubility of the alkaloid the salts of 
morphine are preferred for medicinal use ; they are freely solu- 
ble in water and diluted alcohol, but are insoluble in ether and 
chloroform. Tests: 1. Concentrated 7titric acid strikes with 
morphine and its salts a rich orange-red color, slowly fading to 
yellow ; this will detect gr. 10 q 00 in the dry state (Wormley). 
2. Neutral solutions of ferric chloride or sulphate color them 
deep blue. Other tests are recommended, but these are the 
best. 

Narcotine (C22H23NO7) exists in opium, chiefly in the free state, 
and, being insoluble in water, is left behind when the drug is 
macerated in this menstruum. It occurs in white, tasteless, 
inodorous, needle-like crystals, which are soluble in ether, alco- 
hol, and still more so in chloroform. At one time it was thought 
to possess a portion of the narcotic properties of opium, but it 
is now admitted to be inert in this respect. Its salts, which are 
bitter, have been used in India as stomachics, and as febrifuge 
tonics in the treatment of intermittent fever. 

Codeina {Codeine) C 18 H 2 iN0 3 .H 2 0) exists in opium combined, 
like morphine, with meconic acid, and is extracted in the process 
for obtaining the latter alkaloid, from which it may be separated 
by an alkaline solution, which dissolves the morphine and leaves 
the codeine. It occurs in colorless, octahedral crystals, of a 
bitter taste, soluble in water, alcohol, ether and chloroform. 

Narceine (C23H29NO9) is obtained from the mother liquid left 
after crystallizing out the salts of morphine. C. Bernard 
affirmed that it is the most certain hypnotic of all the opium 
alkaloids. Da Costa's experience shows that it has little effect 



y6 MATERIA MEDICA NEUROTICS. 

on skin or pupil, and that its hypnotic action is uncertain or 
inert, while Eulenberg asserts that to get its hypnotic effects it 
must be given in doses twice as large as morphine. 

Paramorphine (Tkebaine) (Ci 9 H 2l N0 3 ) is said to be a tetanizing 
toxic agent, analogous in its effects to strychnine. 

Papaverine (C 2 lH 2 iN0 4 ) is said to produce some soporific 
action, with a sedative influence on the pulse ; its strength is 
from one-eighth to one-fourth of that of morphine. 

Cryptopine (C21H23NO5) is thought to produce a hypnotic 
influence analogous to that of morphine, though a much feebler 
agent. The statements in regard to the action of the last four 
alkaloids are conflicting. 

Meconic acid is inert, but is interesting as affording the most 
delicate test for opium ; ferric chloride or sulphate produces, 
with even very diluted solutions of opium, the blood-red color 
of ferric meconate, which is not discharged by diluted acids or 
corrosive sublimate. 

Incompatibles. — Alkalies, and astringent infusions containing 
tannic acid, are incompatible with opium ; the former precipitate 
morphine from its soluble combination, while the latter form 
with it an insoluble compound. Many of the mineral salts are 
also decomposed by opium, as lead acetate (lead meconate and 
morphine acetate being formed). The chemical incompatibility, 
however, does not in all combinations interfere with the usual 
physiological action of opium ; for instance, lead acetate and 
laudanum, though incompatible, produce a local sedative effect ; 
in addition, lead acetate, opium or the morphine salts can be 
safely prescribed together in pill form. 

Physiological Effects. — Opium exerts a marked therapeutic 
action in the relief of pain, spasm, wakefulness, nervous irrita- 
bility, and certain forms of morbid discharge, especially from 
the alimentary canal, by a primary stimulant action, antecedent 
to any narcotic influence. In such conditions a tolerance of 
its effects is established, and very large amounts may be taken 
without inducing narcosis. Opium applied locally deadens the 
sensibility of the nerves of a part without influencing the brain 
(Trousseau et Pidoux, vol. ii). In detail its physiological action 
in moderate doses is as follows : Nervous system : the cerebral 
functions are stimulated, accompanied by an agreeable ex- 



NARCOTICS — OPIUM. y/ 

hilaration of the intellectual faculties, followed by drowsiness, 
consciousness being finally lost in sleep, the latter sometimes 
disturbed by dreams. Such sequelae as headache, nausea and 
constipation are common. The reflex function of the spinal 
cord is diminished, and in lethal doses destroyed, death taking 
place from paralysis of the respiratory centre. Pupil : in full 
doses opium contracts the pupil ; but, since the local applica- 
tion of morphine scarcely possesses this power, it follows that 
its action must be systemic, due probably to stimulation of the 
oculo-motor centres. Circulation : the heart's action becomes 
slower and fuller, from a depressing influence on the cardiac 
motor ganglia ; at the same time the arterial tension is raised. 
Respiration : this becomes slower, and the bronchial mucus is 
lessened. Secretions : the intestinal secretions are diminished, 
and, as peristaltic action is retarded, constipation results ; the 
urine is slightly diminished, as is also the saliva ; in one word, 
all the secretions are lessened except that of the skin, which 
is increased. According to Phillips the drug is probably elimi- 
nated by the skin. In regard to its elimination by the kidneys, 
Eliasson's * conclusions are as follows, viz., that large doses 
only can be found in the urine, small ones being undetectable, 
though there appears with the latter in the urine a supposed 
morphia-derivative. In some persons an itching and miliary 
eruption of the skin occurs. Most of the opium alkaloids in- 
crease the excretion of urea. 

To sum up, opium, in man, expends its force chiefly on the 
higher cerebral centres, scarcely influencing the cord at all, unless 
in full doses, while in the lower animals whose cerebra are un- 
developed, as the frog, its acts wholly on the cord, and in them, 
in the absence of a well-developed brain, hypnotism is unusual. 
According to Fothergill, opium produces sleep by causing 
cerebral anaemia and diminished activity of the cells ; and is 
analgesic by lessening the conductivity of nerve-matter. 

When a poisonous dose is taken, the stage of excitement is 
wanting ; giddiness and stupor rapidly come on, with diminu- 
tion in the frequency, though not in the fullness, of the pulse ; 

* Beitrage zur Lehre von dem Schicksal des Morphins im Lebenden Organismus. 
Inaug. Dissertation, Konigsberg, 1882, von W. Eliasson. 



yS MATERIA MEDICA NEUROTICS. 

and these symptoms are soon followed by an irresistible ten- 
dency to sleep, and finally by coma. The breathing is heavy 
and stertorous, the pulse slow and oppressed, and the pupils are 
contracted. If relief be not afforded, the pulse sinks, the mus- 
cular system becomes relaxed, and death ensues, preceded some- 
times in children by violent convulsions. In adults even gr. y^ of 
morphine,* hypodermically, and gr. ivss. of opium,f have caused 
death, but such results are rare. On the other hand, enormous 
amounts (laudanum J fSvij, and in the case of a girl aged nj^,§ 
fSxij) have been taken without fatal consequences. 

In cases of poisoning from opium or its preparations, the stom- 
ach should be immediately evacuated by the stomach pump, if 
possible, or by emetics. Owing to the torpor of the stomach, 
emetics are to be given in double the ordinary doses, and the 
direct emetics are to be preferred, as zinc sulphate (gr. xx-xxx) 
or copper sulphate (gr. v-x), in a tumbler of water. A large 
tablespoonful of mustard flour, or of powdered alum, answers 
very well as an emetic, or apomorphine hydrochlorate (gr. y^-) 
may be given hypodermically. Every means should be taken 
to arouse the patient from his lethargy ; he should be kept 
awake, and made to walk as long as possible ; afterward cold 
affusions, counter-irritation to the nape of the neck and extremi- 
ties, flagellation to the palms of the hands and soles of the feet, 
and, best of all when the coma is profound, the electro-magnetic 
battery should be resorted to, one electrode to be placed above 
the origin of the phrenic nerves, the other over the epigastrium. 
Artificial respiration is also to be practiced. The use of strong 
coffee has proved efficacious ; and stimuli may be given to sup- 
port the system. It has been found that atropine exercises a 
powerful influence as a physiological antidote to opium, these 
drugs acting in an opposite ma7iner on respiration, brain, skin, 
pupil and circulation. A hypodermic injection of atropine sul- 
phate, gr. -fa to -fa, should be administered when there is any 
sign of the failure of respiration, and repeated in fifteen to thirty 
minutes, the frequency and dose depending on the condition of 

* Chicago Med. Exam., May, 1878, p. 493. 

•f-A Treatise on Poisons, 4th ed., p. 713, by Christison. 

% Med.-Chir. Trans., Vol. I, p. 77. 

\ Guy's Hosp. Reports, XI, 1 865, p. 287. 



NARCOTICS OPIUM. 79 

the respiration, not of the pupil or depth of coma. The poison- 
ous action of opium appears to be entirely directed to the nerv- 
ous system, since no local lesions are found after death. 

Opium is largely used as an habitual narcotic in Oriental 
countries, and to some extent in Europe and the United States. 
The effects of indulgence in this species of intoxication are of 
the most destructive character upon both the physical and men- 
tal faculties. A confirmed opium smoker can be recognized, 
generally, by his pallor, emaciation, and contracted pupil. 

In China extensive establishments are devoted to the smoking 
of opium, a form of dissipation that has fewer evils following in 
its train than those caused by the abuse of alcohol ; in fact, the 
" pipe " puts the smoker to sleep, and so effectually prevents the 
crimes so often induced by alcoholic inebriation. It is quite 
possible to indulge in the "pipe" and yet enjoy good health. 
In fact, there are many Chinamen who, smoking in moderation, 
experience no evil effects therefrom. In Japan, opium smoking is 
unknown, as the importation of the drug is rigorously prevented 
by law. As opium is either taken by means of the pipe, hypo- 
dermic injection, or in solution, the expression " opium eating " 
is a misnomer. 

Medicinal Uses. — Of all the articles of the Materia Medica, 
opium enjoys the widest range of therapeutic application. From 
its properties of assuaging pain and inducing sleep it is useful 
in almost all diseases, and should be given in doses sufficiently 
large to produce a decided effect. It is positively contra-indicated 
only where there is a tendency to apoplexy, coma, where asphyxia 
is threatened by copious secretions in the air passages, or where 
there exists an idiosyncrasy with respect to its effects. As an 
anodyne in all injuries, as sprains, railway accidents, burns, etc., 
to relieve pain and resist surgical shock, we have no substitute 
for opium ; and as an hypnotic in delirium tremens and in the 
insomnia and cerebral irritability of fever, mania, etc., it is equally 
invaluable. Prior to an operation, to avert surgical shock, gr. 
%~y$ of morphine may be thrown under the skin before ether- 
ization. In delirium tremens, when the arterial tension is high, 
to enhance its hypnotic effect, it is well combined with sedatives, 
as the bromides, chloral or aconite, as in the following : — 1^ Mor- 



80 MATERIA MEDICA NEUROTICS. 

phinae sulphatis, gr. Y^-){ ; Chloral, gr. xv ; Syrupus tolutani, 
f5ss ; Aquae, ad f§ss, p. r. n. 

From its power of relaxing muscular spasm, it is our most 
efficient resource in colic, either biliary, renal, intestinal or ute- 
rine, and in spasm of the neck of the bladder, being preferably 
given hypodermically, often with atropine. 

In dysentery, cholera and cholera morbus, it forms the basis 
of every variety of treatment, partly for its diaphoretic effects, 
but principally for its action in arresting the intestinal secretions 
and peristalsis. In the collapse of cholera, Dr. Gallagher has 
derived great benefit from morphine subcutaneously. In dysen- 
tery, extract of opium gr. ss is given every two hours, continued 
until an impression is made, or it becomes contra-indicated ; or 
laudanum may be combined in the first stage, with castor oil or 
Rochelle Salt (see Sal Rochelle) ; again, opium is often added to 
astringents, vegetable or mineral, and lastly it may be introduced 
within the rectum, either in starch water or suppository, as a 
curative measure, or for the relief of tenesmus. In conjunction 
with the above treatment, the patient should be placed upon a 
stimulating fluid diet, as milk and brandy. In some cases of 
dysentery opium causes retention of the dejecta, which, by fer- 
menting, irritate the bowel.* In diarrhoea, preferably after the 
exhibition of a cathartic, opium is indicated with a vegetable 
astringent: — Tty Tincturae opii deodoratse, ^x; Tincturae kino 
vel catechu, f3j-ij ; Aquae cinnamomi, f§ss. M. Sig. — Every 
three or four hours ; or if accompanied with flatulency — 1^ 
Extracti opii, gr. ]/^ ; Pulveris camphorae, gr. iij ; Oleoresini 
capsici, gr. j{ ; M. Ft. pil. No. I. Sig. — Every three hours. 

In that form of diarrhoea in which the motions quickly follow 
after eating it is particularly serviceable by restraining peristalsis, 
thus allowing time for digestion. In peritonitis, in which large 
amounts are well borne, morphine hypodermically should be 
administered from the first, and the patient later kept narcotized 
by opium itself; while in puerperal septicaemia it has been found 
more successful than any other remedy. In gastric irritability, 
to check vomiting, in colica pictonum, to relieve the pain of 

* See the Med. and Surg. Hist, of Rebellion, chap, on Dysentery. 



NARCOTICS — OPIUM. 8 I 

rheumatism and gout, opium or morphine are constantly 
employed, and hypodermics of morphine in myalgia, lumbago, 
and the various neuralgiae are the best means of alleviating the 
pain, and not infrequently effect a cure. In cerebro-spinal fever 
it is of the greatest value, no other drug being comparable to 
opium, of which gr. ss-ij may be given hourly, so as to keep the 
patient thoroughly under its influence. In other convulsive dis- 
eases, such as uraemic convulsions (Loomis) and puerperal 
eclampsia, it is an efficient remedy ; moreover, an approaching 
paroxysm of malarial fever, pernicious or intermittent, may be 
prevented, if necessary, by the timely injection of morphine. 

For the relief of the cough of pulmonary affections, opium 
has no equal in the Materia Medica, but is generally contra-indi- 
cated before the secretions are established, except in minute 
doses combined with a diaphoretic, as in Dover's powder. Good 
formulae are : 1^ Morphinae sulphatis, gr. ij ; syrupus ipecacu- 
anhas fSijss ; syrupus pruni virginianae, f§iij ; aquae ad. f§vj. M. 
et Sig. — Tablespoonful every three hours. Ity Tincturae opii 
camphoratae, glycerini, et syrupus pruni virginianae aaf§j. M. 
et Sig. — A teaspoonful, repeated as necessary. 

In the first stage of pleurisy, morphine hypodermically, 
aconite, with a large dose of quinine per orem, and perhaps a 
blister, is the best means of relieving the pain and cough and 
hindering effusion. 

Morphine subcutaneously will generally relieve a paroxysm 
of asthma, -although without curative power, and Dr. Allbutt 
recommends it to alleviate cardiac dyspnoea, which statement 
the editors can confirm. 

In sunstroke, too, good results have been obtained from mor- 
phine injections with antipyretic and sedative treatment (Dr. 
Jas. Hutchinson). Opium and recently its alkaloid codeine have 
been highly lauded in the treatment of diabetes ; and, lastly, in 
all gangrenous processes its use is indicated. 

Caution must be enjoined in prescribing opium in chronic 
diseases, for fear of originating the opium habit, which may be 
contracted where there is much suffering, on account of the 
speedy relief afforded by it. 

Topically \ it is used in the form of ointment to relieve the pain 
of boils, carbuncles and hemorrhoids, either alone or with bella- 
6 



82 MATERIA MEDICA NEUROTICS. 

donna : ^ Extracti opii, extracti belladonnae aa gr. xxj ; acidi 
tannici gr. x ; adipis Sss. M. et Sig. — Apply to piles. In supposi- 
tory, it is serviceable both for its local and constitutional effects, 
in strangury, anal fissure, proctitis, prostatitis, uterine disorders, 
and to control chordee : 3^ Extracti opii, gr. j ; extracti bella- 
donnae, gr. ss. M. ft. supposit. no. i. As a sedative collyrium, in 
aqueous solution, in the form of lead water and laudanum, as an 
anodyne lotion, or as an addition to poultices, it is daily employed. 

Administration. — The ordinary dose of opium as an anodyne 
and hypnotic is gr. ss-ij. Much larger doses are, however, 
called for in many diseases ; and when it is administered for a 
length of time, as a narcotic, the dose must be gradually in- 
creased. To infants and very old persons it is to be given with 
great caution. Some of its disagreeable effects may be obviated 
by the addition of other remedies ; thus, if it constipate, by com- 
bining it with aloes, or if there be anorexia, with capsicum. 

Its hypnotic action is aided by the bromides, chloral, urethan, 
paraldehyde and hypnone; its analgesic, by belladonna and 
cocaine, but it should not be prescribed in full doses with these 
agents. 

The following are the officinal preparations of opium : — 

Opii Pulvis {Opium Powder). Used in making most of the 
opium preparations. It should contain not less than 12 nor more 
than 16 per cent, of morphine. This, as Dr. Squibb has pointed 
out, causes a great variation in their strength, depending on the 
percentage of morphine in the powdered opium ; thus laudanum 
Sj may contain from gr. 5.44 to gr. 7.25 of morphine. 

Opium Denarcotisatum {Denarcotised Opium). Opium freed 
from narcotine, etc., by means of ether, and containing 14 per 
cent, of morphine. Dose, gr. ss-ij. 

Pilule Opii {Pills of Opium). Each pill contains gr. j. 

Extractum Opii {Extract of Opium). Dose, gr. \. 

Trochisci Glycyrrhiz^e et Opii {Troches of Glycyrrhiza and 
Opium). Wistar's cough lozenges, are very useful to allay irrita- 
tive laryngeal or pharyngeal cough. Each troche contains gr. -^ 
of extract of opium. 

Emplastrum Opii {Opium Plaster). Made by mixing extract 
of opium with Burgundy pitch and lead plaster. 

Pulvis Ipecacuanha et Opii. Powder of Ipecac and Opium. 



NARCOTICS — OPIUM. 83 

Dover s Powder is a most valuable anodyne diaphoretic, exten- 
sively prescribed in diarrhoea, dysentery, rheumatism, bronchitis, 
pneumonia, etc. Dose, gr. x, containing gr. j of opium and 
ipecac each. 

Tinctura Opii (Tincture of Opium). Laudanum. Contains 
10 per cent, of powdered opium. It should be recollected that 
the opium from which these preparations are made contains 
from 2 to 6 per cent, more morphine than that formerly em- 
ployed. This is the most commonly used of all the officinal 
preparations of opium. When long kept, particularly if exposed 
to the air, it becomes thick from evaporation of the alcohol, and 
its strength is much increased. Dose, ^xij, or about 25 drops, 
equivalent to opium gr. j. There are 120 drops in f5j. Lauda- 
num is much used in the form of enema. 

Tinctura Ipecacuanha et Opii [Tincture of Ipecac a?id 
Opium). Dose, ^x-xx. 

Tinctura Opii Camphorata {Camphorated Tincture of Opium). 
Paregoric Elixir. Contains opium in diluted alcohol, with ben- 
zoic acid, oil of anise, glycerin and camphor. Dose, f5ss, or 
a tablespoonful, containing rather less than a grain of opium. 
A favorite preparation for children. 5 to 20 drops may be 
given to an infant. 

Tinctura Opii Deodorata [Deodorized Tincture of Opium). 
In preparing it, the narcotine and odorous ingredients of opium 
are got rid of. A valuable preparation. Dose, ^xij. 

Acetum Opii [Vinegar of Opium). Black Drop. Dose, ^xij. 

Vinum Opii [Wine of Opium). Sydenham 's Laudaitum. Dose, 
^xij. 

Morphine Sulphas {Morphine Sulphate), Morphine Acetas 
(Morphine Acetate), Morphine Hydrochloras (Morphine Hy- 
drochlorate), are the officinal salts of morphine, made by satu- 
rating the alkaloid with sulphuric, acetic or hydrochloric acids. 
The sulphate and hydrochlorate occur in the form of snow- 
white, feathery crystals, the acetate (which is not very stable) 
as a white powder. They have a bitter taste, are all freely 
soluble in water and alcohol, and produce analogous medicinal 
effects ; the sulphate is most employed in this country. The 
salts of morphine possess the analgesic and hypnotic, but not the 
diaphoretic properties of opium, and are considered less apt to 



84 MATERIA MEDICA NEUROTICS. 

produce headache, nausea or constipation. They are peculiarly 
adapted to the hypodermic and endermic methods of application. 
Dose, gr. \- \, equal to opium gr. j. Magendie's solution, not 
officinal, used hypodermically, contains gr. xvj to fSj ; but for 
this purpose compressed tablets, or the powder dissolved in 
water as required, are preferable, and its efficiency is often pro- 
moted by the addition of atropine. 

Troches of Morphine and Ipecac (Trochisci Morphinse et Ipe- 
cacuanhas) ; each troche contains gr. -^ of morphine sulphate 
and gr. -^ of ipecac. 

Pulvis Morphine Compositus [Compound Powder of Mor- 
phine) {Tullys Powder). Contains morphine sulphate (i part), 
mixed with camphor, liquorice and calcium carbonate (of each 
20 parts). 

Codeina (Codeine) is officinal, and has been found to possess 
uncertain narcotic powers, gr. j having failed to be hypnotic, 
while gr. iv have caused insomnia and slight delirium ;* again, 
gr. v have produced no effect (S. Weir Mitchell). It may be 
used as an anodyne and hypnotic, and appears to possess a 
sedative effect on the vagus also. It has been used with success 
in gastrodynia, to allay troublesome cough, and is said to be of 
service in glycosuria. Dose, gr. ss-ij, in water, with elixir of 
orange. 

LACTUCARIUM. 

Lactucarium {Lettuce Opium) is the concrete milk-juice of 
Lactuca virosa, the garden lettuce {Nat. Ord. Composite), and 
is obtained from incisions in the stem of the plant, during the 
period of inflorescence. Two varieties are found in the market : 
English and German lactucarium, the latter being inferior. It 
occurs in small, brownish lumps, with an opiate smell. The 
active principle, termed lactucin, is said to possess less hypnotic 
power than the crude drug. 

Effects and Uses. — Lactucarium possesses very feebly the ano- 
dyne and hypnotic qualities of opium. It may be given where 
opium disagrees from idiosyncrasy. Dose, gr. x ; of the syrup 
f5ij-iv ; of the fluid extract £5j . 

* British Medical Journal, 1874, I, 478. 






NARCOTICS PARALDEHYD. 85 

PARALDEHYD. 

This remedy, not officinal, is a polymeric modification of ethyl 
aldehyd (C 2 H 4 0) 3 , and is formed by treating it with a mineral 
acid. 

It is a colorless liquid, boiling at about 25 5° F. and solidify- 
ing into fusible crystals at 5 1° F. It has an acrid taste, a volatile 
odor like that of chloroform, is more soluble in cold than in hot 
water, and has a sp. gr. of .998. 

Physiological Effects. — The action of paraldehyd has been 
studied by Drs. Cervello,* Morselli,t AlbertoniJ S. A. Popoff,|| 
Andruzski,§ Carl von Noorden,Tf Berger, Langreuter,** Dana 
and others, all of whom agree that it is a hypnotic and sedative, 
lowers reflex activity, and is comparatively free from unpleasant 
after-effects. Locally : it is strongly antiseptic and anti-fermen- 
tative. Nervous System : the action of paraldehyd is exerted 
on the hemispheres, medulla and cord, in the order named 

(Coudray).ft 

Small doses cause a temporary increase followed by depres- 
sion of the excitability of the cerebral cortex, and quiet, tranquil 
sleep. When a large dose is taken the primary stimulation is 
absent. The pupils are unaffected. Paraldehyd depresses and 
in toxic doses paralyzes the respiratory centre of the medulla, 
cardiac innervation being unaffected. The reflex centres of the 
cord and the peripheral endings of sensory nerves are depressed, 
causing a diminution, and, if a toxic dose have been taken, a sub- 
sequent loss of sensibility, reflex action, and voluntary motion ; 
the excitability of motor nerves and of striated muscles remains 
unimpaired. 

Circulation : even large doses do not affect the circulation nor 
the arterial tension. If, however, toxic doses be administered 

* Archiv. Ital. de Biologie, 1884, p. 1 13. Archiv. pour le Science Med., Vol. VI. 
El Pisani, Disp. IV, V and VI. 

f Gazz. degli Ospitali, Jan. 1 883, Nos. IV, V and VI. Rev. Sper. di Fren. e di 
Med. Leg., 1 882. El Pisani Fasc, iii, loc. cit. 

\ Riv. di Chim. Med. e Farmaceu-tossico e Farmaco., Feb. and Mar., 1883. 

|| Medilz. Obozrenie, Fasc. I, Vol. XXI, 1884, p. 69. 

\ Arkhiv. Psykhiatriee, etc., Vol. iv, Fasc. I, 1884, p. I. 

1f Centralbl. filr Klin. Med., March 22, 1884. 

"** Centralbl. filr Klin. Med., loc. cit. Berlin. Klin. Wochensch., June 16, 1884. 

ft These de Paris, 1 886. 



86 MATERIA MEDICA NEUROTICS. 

the cardiac frequency is at first decreased but soon increased, 
the individual beats being weaker than normal, and a gradual 
fall takes place in the blood pressure, the heart finally stopping 
in diastole. It is said that the cardiac arrest is only due to 
cessation of the respiratory act and that it may be prevented 
by resorting to artificial respiration. 

Respiration and temperature : more or less marked slowing of 
respiration always occurs, and if a sufficiently large dose be 
taken, there is final respiratory paralysis of central origin. The 
temperature is slightly lowered. 

Alimentary tract: as a rule, no gastro-enteric disturbance 
occurs on waking ; but if the dose be large and the medicine 
administered for a prolonged period, gastric catarrh and dis- 
turbed nutrition may result (Andruzski), though most observers 
have not seen these effects following its prolonged use. Secre- 
tion : the urine is increased in amount. Prof. Popoff found that 
large intravenous injections destroyed the red corpuscles and 
produced haematuria. Elimination takes place through the kid- 
neys and the lungs, the odor of paraldehyd having been detected 
in the breath twenty-four hours after its administration. 

Medicinal Uses. — Paraldehyd is chiefly used as a hypnotic in 
the insomnia of various mental disorders, or in insomnia from 
prolonged mental work, or where other hypnotics have proved 
insufficient or are contra-indicated. Its good effects are especially 
conspicuous where insomnia is not due to pain or to mechanical 
causes, such as dyspnoea or cough. In the insomnia of acute 
or chronic mania, delirium tremens, dementia paralytica, hys- 
teria, etc., it is useful by procuring sleep, but otherwise exerts 
no effect upon the disease. 

It has also been used with occasional benefit as an anodyne 
and hypnotic in neuralgic affections (Morselli). From its depress- 
ing influence on the reflex functions of the cord it has been 
given in epilepsy, and according to Riggi, is as useful in this 
affection as potassium bromide. 

Cervello found that paraldehyd was a physiological antagonist 
to strychnine, preventing the toxic symptoms of that alkaloid if 
given before their appearance or causing their subsidence if 
administered after their development, and acting whether used 
with, before or after strychnine. This action is not reciprocal, 



NARCOTICS URETHAN. 87 

as strychnine appears to exert little or no influence over 
paraldehyd-narcosis. Paraldehyd is contra-indicated in severe 
gastric disease and in advanced phthisis with affection of the 
throat (Carl von Noorden). 

Administration. — Dose f5ss— ij. It is better given in small 
doses repeated every hour as required, than in a single large 
dose (Strahan) ; * more than gtt. lx is rarely required to produce 
sleep. Paraldehyd may be administered in capsule or emulsified 
with acacia and syrup of almonds, which disguises somewhat its 
unpleasant taste. It has also been exhibited in suppository. 

HYPNONE. 

This substance (unofficinal), phenyl-methylacetone, acetophe- 
none, or acetaphone is a recent addition to the narcotic group 
of remedies. It is a fluid having a sp. gr. of 1.032, crystallizing 
in large flakes at about 50 F. Its properties have been inves- 
tigated by Popoff, Dujardin-Beaumetz, Laborde,f Magmen % and 
others, who have ascertained that it possesses decided hypnotic 
properties. Injected into the vein of a dog it caused sleep, anal- 
gesia, absence of the ocular reflex, dilated the pupils, and killed 
by asphyxia (Laborde). It is eliminated in part by the lungs, 
its odor being perceptible upon the breath. Large doses are 
said to irritate the stomach. What the toxic dose is has not yet 
been determined, though as much as gtt. vj-viij have been taken 
without disagreeable effects. 

It is probably indicated in the same range of diseases to which 
paraldehyd is applicable, especially in uncomplicated insomnia. 
Dose gtt. ij— v or perhaps more, in capsule or with glycerin and 
syrup. 

URETHAN. 

Urethan (CHNO), unofficinal, is ethyl carbamate and occurs 
in white crystals, odorless, almost tasteless, and readily soluble 
in water. Its effects have been studied by Garnier,§ Hiibner and 
Strieker, 1 1 and others. It acts principally on the cerebrum, at first 

* London Lancet, Jan., 1885. 

f Comp. Rend, des Seances de la Soc. de Biol., t. II, Oct., 1885. 

% These, Lyon, 1 886. 

\ Revue Med. de Vest, 1886, p. 126. 

[| Deutsche Med. Wochensch., April, 1886, p. 236. 



88 MATERIA MEDICA — NEUROTICS. 

stimulating but soon depressing its functions and inducing, in 
suitable cases, tranquil sleep, usually without unpleasant after 
effects. The circulation and respiration are also somewhat de- 
pressed, the reflexes lowered, and the temperature reduced. It 
is not an analgesic, and will not produce sleep when insomnia is 
due to pain. It is feebly toxic, causing in overdoses insensibility 
and coma, though 3iij have, been taken without alarming results. 
Large doses of urethan decrease the nitrogenous elements of the 
urine, by which fluid it is excreted (Gamier). 

As a hypnotic it is useful in simple insomnia when other 
remedies are contra-indicated on account of their action on the 
heart and respiration. It has been given also with benefit in 
epilepsy, chorea, and uraemic convulsions. In large doses it is 
antagonistic to strychnine but is not sufficiently powerful to be 
used as an antidote to that poison. The dose ranges from gr. 
ij— 5j, or more, dissolved in water and flavored with elixir of 
orange. Hypnotic effects can usually be produced by doses of 
gr. xv-xxx in suitable cases. Capsules may be used as a means 
of administration. 

BELLADONNA. 
Belladonnse Folia, Belladonna Leaves ; Belladonna Radix, Belladonna Root. 

Atropa Belladonna, or Deadly Nightshade (Nat. Ord. Solan- 
aceae), is a European perennial plant, with herbaceous, branched, 
downy stems, about three or four feet high, large ovate leaves 
of a dull-green color, and drooping, bell-shaped purple flowers. 
The whole plant possesses narcotic properties, but the leaves and 
root only are officinal. The root should be obtained from plants 
more than two years old ; the dried root is long, round, from one 
to seven inches in thickness, branched, of a reddish-brown color, 
of little odor, and a feeble sweetish taste. 

The physiological properties of belladonna depend on the 
presence of an alkaloid termed atropine, combined with malic 
acid, which is found in all parts of the plant. It is officinal, and 
is prepared from the root by exhaustion with alcohol, afterward 
adding sulphuric acid, precipitating with potassa, dissolving the 
atropine in chloroform, and then evaporating the chloroform. 
Atropina (Atropine) (C 17 H 2 3N0 3 ) occurs in the form of yellowish- 
white, silky, prismatic crystals, without smell, but of a bitter, 
acrid taste, soluble in alcohol, more so in ether, still more so in 



NARCOTICS BELLADONNA. 89 

chloroform, but only partially soluble in water. .The best test 
is bromine, in hydrobromic acid, which produces a yellow amor- 
phous precipitate, soon becoming crystalline, and will detect at 
least gr. 2 5 \ (Wormley) ; auric chloride gives with atropine 
solution a yellow amorphous precipitate ; the physiological test 
should also be applied by dilating the pupil of a rabbit or a cat 
by local application to the eye. It is a most energetic poison, 
producing analogous effects to those of belladonna, but much 
more powerful. Another alkaloid termed belladonnine has been 
isolated, which, according to Ladenburg, is isomeric with hyos- 



Fig 6. 




ATROPA BELLADONNA \ A, ROOT \ B, LEAVES. 

cyamine and atropine. It has, however, a lower fusing point, and 
yields a different salt with gold chloride. 

Physiological Effects of Belladonna. — The authorities consulted 
for this article are Meuriot,* Fraser,f Bezold and Bloebaum, % 
Lemattre,|| and Donders.§ Belladonna or atropine applied locally 
diminishes sensation and can be absorbed through the unbroken 



De la Method. Phys. de la Belladonne," 1868; an elaborate monograph, 
f Trans. Roy. Soc. Edin., 1869, p. 449. 
\ Wicrzburger Physiol. Unlersuchungen, 1867, p. 3. 
|| Arch. Gen. de Med., VI, 6 ser., p. 173. 
I « Accom. and Refrac. of the Eye," 1864, p. 558. 



gO MATERIA MEDICA NEUROTICS. 

skin. Nervous system : in small doses it is a cerebral exhilarant, 
tending in larger doses to produce hallucinations and delirium. 
The exact quantity required to induce these effects cannot be 
stated, as individual susceptibility differs. Belladonna dilates 
the pupil, in whatever way exhibited. When dropped into the 
eye it brings about dilatation probably by paralysis of the end- 
organs of the third nerve and stimulation of the sympathetic, 
while internally it is also thought to cause pupillary dilatation 
by a local action. In large doses the excitability of the motor 
and sensory nerves is impaired by this drug, but the contrac- 
tility of striated muscles remains unaltered. It tetanizes the 
cord, and heightens its reflex function (Ringer, nth ed., p. 401). 
Circulation : it increases the heart's movements by stimulating 
the cardiac ganglia of the sympathetic and paralyzing the 
peripheral ends of the pneumogastrics, and as it stimulates the 
vaso-motor centre, an increase in blood pressure also takes place. 
Respiration: is quickened by stimulation of the respiratory 
centre. Temperature : in small doses it increases temperature 
and in large reduces it. Secretion : belladonna checks the 
salivary secretion by paralyzing the peripheral endings of the 
chorda tympani nerve in the submaxillary gland, hence the dry- 
ness of the mouth and throat experienced after its use. Its effect 
on the urinary secretion is doubtful, but it unquestionably aug- 
ments the solids ; it effectually checks the perspiration by a local 
paralyzing action on the peripheral nerve end-organs ; upon the 
intestinal glands its action is uncertain, but it certainly induces 
intestinal peristalsis. Atropine is eliminated by the kidneys. 
Belladonna, however used, has the power to check the secretion 
of the mammary glands. In larger doses it causes dilatation of 
the pupils, loss of vision, giddiness, constriction of the throat, 
difficulty of deglutition and articulation, increased heart-action, 
quickened respiration, elevation of temperature, nausea, with 
occasional vomiting and purging, and sometimes a red eruption. 
When excessive doses are taken the temperature of the body 
falls, the muscular system is relaxed, sensation is impaired, the 
pulse fails, and maniacal delirium sets in, followed by coma, syn- 
cope and death, often preceded by convulsions. The fatal dose 
of atropine cannot be precisely stated, as death has followed 



NARCOTICS BELLADONNA. 9 I 

gr. -^ per orem,* while recovery took place after swallowing 
gr. jss, and gr. xxx-xxxv of the extract of belladonna taken by 
a child in mistake for liquorice. f Post-mortem examinations 
show that the action of the poison is not confined to the cerebro- 
spinal system, but that it is attended with inflammation of the 
digestive organs. Poisoning by belladonna is treated by evacua- 
tion of the stomach, cathartics, and, if coma occur, by the 
electro-magnetic battery. Pilocarpi?te and physostigma are the 
physiological antidotes, or hypodermic injections of morphine 
may be administered. As atropine and its salt is decomposed 
and rendered inert by prolonged contact with caustic alkalies, 
the solutions of potassa and soda are recommended as antidotes 
for belladonna, and are medicinally incompatible with it ; lime 
solution is said to have the same action. Applied to the tem- 
poral region, belladonna causes dilatation of the pupil ; and 
accompanying its mydriatic action is paralysis of accommodation 
and a diminished intra-ocular pressure. 

Medicinal Uses. — Belladonna is one of our most highly es- 
teemed anodyne and antispasmodic remedies. It is destitute of 
hypnotic effect, and, on the contrary, has a tendency to occasion 
wakefulness. In the treatment of neuralgia (extract, gr. ss) it 
ranks at the head of the narcotics, and is extensively employed 
both alone and with quinine sulphate (gr. x) and general tonic 
treatment. In myalgia, lumbago and sciatica, the subcutaneous 
injection of atropine gives speedy relief and may be advanta- 
geously combined with morphine. It should be given until dry- 
ness of the throat, dilatation of the pupil, or some disorder of 
vision are produced. Its powers of allaying spasm have been 
found very efficacious in the treatment of whooping-cough, in 
which atropine sulphate gr. ^far ma y ^ e gi yen m water once 
daily to children one to four years of age, diminished or increased 
according to the severity of the paroxysms and the effect pro- 
duced. In asthma, a nightly dose at bedtime large enough to 
produce constitutional effects often prevents the paroxysm and, 
in some cases, cures the disease. In lead colic (see lead), and in 
laryngismus stridulus, belladonna ranks among the best anti- 



* Journ. de Chimie Med., i860, p. 529. Roux. 
f Cincinnati Lancet and Observer, 1861, p. 609. 



92 MATERIA MEDICA NEUROTICS. 

spasmodic remedies. In the latter disease, combined with the 
bromides, and, in the absence of laryngitis, repeated sponging 
of the neck with cold water, it is most efficacious. 

Combined with opium in suppository, it is used for the relief 
of dysmenorrhcea, but is only palliative, as the treatment of this 
symptom depends upon its cause. It has been occasionally 
employed with advantage in epilepsy. As a stimulant to the 
circulatory system, it may be used wherever syncope is threat- 
ened from cardiac failure. By its influence in relieving irrita- 
bility of the bladder, it is probably the best remedy for the 
nocturnal incontinence of urine of children, for which purpose 
gtt. iij-v of the tincture may be cautiously given three or four 
times a day, and the child waked at midnight to pass water. 

In habitual constipation due to atony of the muscular fibre, 
after a dose of castor oil, the following is efficacious to reestab- 
lish peristalsis : 1^ Extracti belladonnas gr. 2V ; aloin gr. -^ J 
extracti nucis vomicae gr. -J-. M. ft. pil. 1. S. one pill after meals 
t. d. for some time. It is used, too, in cases of poisoning by 
opium, principally for its stimulating effect upon the respiratory 
centres (see p. 78). Hypodermic injections of atropine gr. -^y— 
•^q- are useful in checking colliquative night-sweats, especially in 
phthisis, and may be advantageously combined with minute doses 
of morphine, to relieve the cough ; the following also is a good 
combination : 3^ Atropinae sulphatis gr. -^ ; strychninae sul- 
phatis gr. j ; codeinse gr. x ; aquae f §iiss. M. S. teaspoonful 
morning and evening. 

And, lastly, from its anhydrotic action, it is useful in ptyalism. 

As a topical remedy, belladonna is employed as an anodyne, 
and also to relieve rigidity of the os uteri in labor, and in spas- 
modic urethral stricture, the application of the ointment to the 
constriction by a bougie is efficacious. A plaster, ointment or 
solution of atropine may be applied to the breasts of nursing 
women as a galactafuge ; while the plaster alone, to the back, 
often relieves lumbago and sacralgia. The liniment may be 
used to relieve muscular rheumatism, neuralgia and other local 
pains, and is advantageously combined with fluid extract of 
aconite as a topical remedy in severe neuralgia. A suppository 
(gr. ss-j of the extract) is sufficient for the relief of strangury ; 
and in cystitis this combined with a milk diet and rest in the re- 



NARCOTICS BELLADONNA. 93 

cumbent posture, at the same time keeping the urine alkaline by 
liquor potassae, is one of the best plans of treatment. The local 
use of atropine in diseases of the eye is of the greatest import- 
ance ; solutions of the alkaloid or its sulphate (gr. i-ij to f gss. 
of water), may be dropped into the conjunctival sac, to relieve 
pain and photophobia, to determine the refraction of the eye 
from its influence on accommodation, in the diagnosis of sus- 
pected cataract, in operations for cataract, prolapsus iridis, and 
ulcers of the cornea. A good treatment for iritis is the instilla- 
tion of atropine solution until the pupil is widely and evenly 
dilated, at the same time giving mercury internally, and continu- 
ing all until the danger of synechia is passed. Gelatine wafers, 
containing gr. -^ to yj-g- of atropine, are used to dilate the pupil 
for ophthalmic purposes. It should be recollected that the local 
application of belladonna, or its alkaloid, may produce the con- 
stitutional effects of the drug. 

Homatropine. — This is made from tropine amygdalate and 
dilute hydrochloric acid, atropine having been split into tropine 
and tropic acid. It is similar in its effects to atropine, though 
weaker, retards the heart's action, and renders it irregular. 
Applied to the pupil, it quickly brings about wide dilatation, 
and, moreover, is unirritating, hence it is an acquisition in ocular 
therapeutics. 

Administration. — The dose of the powder of the root or leaves 
is gr. j, to be repeated and increased till dryness of the throat, 
dilatation of the pupil, and dimness of vision are produced. The 
abstract is twice as strong as the powdered root, from which it is 
prepared. The tincture (15 parts of the leaves to diluted alcohol 
q. s. to make 100 parts of tincture — dose, gtt. 15 to 30) and the 
alcoholic extract are also officinal. Of the fluid extract of bella- 
donna root the dose is *RJ— v. For external use, a plaster 
(emplastrum belladonnce), an ointment (unguentum belladonnce), and 
a liniment {linimentum belladonnce, containing fluid extract 95 per 
cent., and camphor 5 per cent.) are employed. 

Atropina {Atropine), or its officinal salt Atropine Sulphas 
{Atropine Sulphate), is generally employed medicinally instead of 
belladonna, as it represents the activity of the drug, because of 
the smallness of the dose required, and its fitness for hypodermic 
use. The sulphate, which is obtained by mixing the alkaloid 



94 MATERIA MEDICA NEUROTICS. 

with water, and gradually adding diluted sulphuric acid until the 
alkaloid is dissolved and the solution is neutral, when the salt is 
obtained by evaporation, consists of a white, slightly crystalline 
powder, very soluble in water and alcohol, but insoluble in ether. 
As a medicinal agent, the salt is preferable because more soluble. 
Dose, gr. ^ 6 V 

STRAMONIUM. 
Stramonii Folia, Stramonium Leaves; Stramonii Semen; Stramonium Seed. 

Datura Stramonium, or Thorn-Apple, sometimes called James- 
town weed {Nat. Ord. Solanacese), is an annual indigenous plant, 
which grows very abundantly in waste grounds in all parts of the 



Fig 




DATURA STRAMONIUM. A, SEED. 



world. It has a forked, branching stem, from three to six feet 
high, ovate, toothed leaves, large funnel-shaped white or pur- 
plish flowers, which appear in midsummer, and ovate capsules, 
filled with numerous kidney-shaped, brownish-black seeds. The 
odor of the plant is strong and disagreeable, and its taste bitter 
and nauseous. It loses these properties very much when dried, 
but the process does not appear to weaken its narcotic qualities. 
The leaves and seeds are officinal, but the seeds are most pow- 
erful from containing most daturine. 

The active principle of Stramonium is an alkaloid termed 



NARCOTICS HYOSCYAMUS. 95 

daturine, found combined with malic acid, which is chemically 
identical with atropine, and possesses analogous properties. 

The physiological effects of stramonium are closely allied to but 
weaker than those of belladonna. From its common occurrence 
in every part of the country, cases of poisoning from this weed 
are very frequent, particularly with children, who are fond of 
swallowing the seeds. A case is reported by Calkins * of a boy, 
aged four years, who swallowed a tablespoonful of the seeds, but, 
as he soon vomited them, no ill effects resulted. The treatment 
laid down for the relief of poisoning from belladonna is applicable 
to these cases. It is eliminated f by the urine. 

Medicinally ', it is sometimes prescribed internally in neuralgia ; 
and in spasmodic asthma, gr. xxv of the dried leaves are smoked 
with great relief in cigarettes or pipes, the smoke being drawn 
into the lungs and the inhalation frequently repeated. Topically, 
daturine is occasionally used by oculists to dilate the pupils when 
other mydriatics cannot be employed. Stramonium is an excel- 
lent anodyne application, in the form of cataplasm and ointment, 
to irritable ulcers, bed-sores and hemorrhoids. 

Administration. — The dose of the powdered leaves is gr. ij ; of 
the seeds, gr. j, to be repeated and gradually increased till effects 
are produced. Dose of the extract (of the seed) gr. x / 2 . The fluid 
extract (dose ^ij-v), the tincture (10 per cent, of the seed, dose 
^v-xxx), and the ointment, made by mixing the extract with 
benzoinated lard, are also officinal. 

HYOSCYAMUS. 
Hyoscyami Folia, Hyoscyamus Leaves. 

Hyoscyamus niger, or Henbane {Nat. Ord. Solanaceae), is a 
native of Europe, and is naturalized in the northern parts of the 
United States. It grows to the height of about two feet, with 
large sinuated, pale-green leaves, and flowers of a straw-yellow 
color. The whole plant has narcotic properties ; but the leaves 
only are officinal. They should be gathered from plants of the 
second year's growth when in flower. The active properties of 



* Am. Med. Monthly, 1 856, p. 220. 

f Arch, de Physiologie A r orm. et Pathol., t. iii, 1870, 215. Oulmont et Laurent; 
De l'Hyoscine et de la Daturine. 



9 6 



MATERIA MEDICA NEUROTICS. 



the plant depend upon two alkaloids, one crystallizable, termed 
hyoscyamine (Q7H03NO3), isomeric with atropine ; the other an 
amorphous, brown liquid, to which Ladenburg has given the 
name of hyoscine, and which, though isomeric with hyoscyamine, 
differs from it very materially. Hyoscyamine can be split into 
tropic acid and tropine, hyoscine into tropic acid and pseudotro- 
pin<z ; and both alkaloids unite with acids to form salts. 

Effects and Uses. — The effects of henbane on the system much 




HYOSCYAMUS NIGER. 



resemble those of belladonna. They differ from those of opium in 
their comparatively feeble hypnotic effect, and in their relaxing 
influence on the bowels. In large doses it causes dilatation of the 
pupil, delirium, loss of vision, and, generally, sleep. Hyoscyamine, 
when pure, is identical in its action with atropine, and recent 
researches have shown that hyoscine is the hypnotic principle of 
henbane, and antagonizes pilocarpine (A. Sohrt). They are both 






NARCOTICS HYOSCYAMUS. 97 

eliminated by the kidneys.* Dr. Whitef describes the case of 
a woman who took foxj of the tincture by mistake for black 
draught ; she became immediately giddy, then delirious, with 
much dryness of the throat, but eventually recovered. In cases 
of poisoning, the same general treatment is to be pursued as for 
belladonna, from which it cannot be distinguished. According 
to GnauckJ morphine is the best antidote. Henbane may be 
used remedially in the same diseases as belladonna and stramo- 
nium, than which it is, however, less active. It has been adminis- 
tered also in insomnia, where opium is objectionable from its con- 
stipating or nauseating influence, and as a hypnotic to children. 
The extract is frequently added to purgative pills to increase their 
efficiency and prevent griping. Externally, hyoscyamus is em- 
ployed in the form of cataplasm or fomentation to painful swell 
ings and ulcers, and hyoscyamine sulphate may be used to dilate 
the pupil, in the same manner as belladonna. 

Dose of the powder, gr. v-x ; of the abstract \ gr. ss-ij. Tinc- 
ture (15 per cent.), dose, f5j. An alcoholic extract (a preparation 
of uncertain strength — dose gr. ij, increased until some effect is 
produced) and a fluid extract (dose gtt. x-xx) are also officinal. 

Hyoscyamine Sulphas [Hyoscyamine Sulphate) occurs in the 
form of small, yellowish-white scales or crystals, or a yellowish- 
white powder, deliquescent on exposure to the air, without 
smell, but possessing an acrid, bitter taste. It is very soluble 
in water and alcohol. Hyoscyamine is useful in chorea and 
various forms of tremor,§ in the dose of gr. -^-q hypodermically. 
It is highly recommended by Lawson, and confirmed by Brown,|| 
to quiet the violence of mania, though without curative effect. 
The dose has been variously stated by different authors, due, 
evidently, to the variable purity of the drug ; as, however, gr. -^ 
of the pure alkaloid has produced violent poisoning, Tf it is better 
to begin with gr. yj-^-, and gradually increase the dose until some 
effect is produced. 



* Arch, fiir Experimentelle Pathol, und Pharmacol., Vol. xxn, R. Robert und 
A. Sohrt; Arch, de Physiologie Norm, et Pathologiqne, t. iii, 1 870, .p. 215. De 
l'Hyosciamine et de l'daturine par Oulmont et Laurent. 

f Lancet, July, 1873, p. 8. \ Med. News, Jan., 1886. Da Costa. 

\ Arch, de Neurologie, July, 1883. || Brit. Med. Jour., November 25th, 1882. 

\ Lancet, 1879, 1, 474. 
7 



98 MATERIA MEDICA NEUROTICS. 

Hyoscine Hydrochlorate (unofficinal) is freely soluble in 
water, and resembles atropine physiologically, but with a more 
decided hypnotic action and less delirium. Its' use is followed 
by headache and malaise, and Gnauck states that it slows the 
pulse decidedly. It is said not to cause dryness of the throat. 
Topically, gr. ss to water foj, it widely dilates the pupil, though, 
in this respect, it is less persistent than atropine. It has been 
administered in whooping-cough and asthma, and Mitchell 
Bruce * advises it in mania and insomnia, to relieve the delirium 
and restlessness. G. Thompson, f Medical Superintendent, 
Bristol Asylum, has used it successfully, gr. -^-Jif, repeated, to 
allay excitement and produce sleep in acute and recurrent mania ; 
but more experience with it is required in order to determine its 
range of therapeutical uses. Dose, gr. -^ ; hypodermically, gr. 
Y^q, both to be cautiously used at first. 

DUBOISIA DUBOIS^E FOLIA. 

The leaves of the Duboisia myoporoides {Nat. Ord. Solana- 
ceae), a tree-like shrub of Australia. They are three to four 
inches long and one inch broad, entire, smooth and lanceolate. 
An alkaloid, duboisine, the salts of which are readily soluble in 
water, has been isolated, isomeric with atropine and resembling 
it in action. Duboisine, internally, produces almost similar effects 
to those of atropine. The mental excitement, however, which it 
causes is followed by stupor. Its effect is best seen on the 
pupil, which it dilates, no matter how exhibited. It differs from 
atropine in causing more rapid dilatation and paralysis of accom- 
modation, both of which are more fugitive, and in being less 
irritating. Its physiological action is antagonized by opium and 
physostigma. The use of duboisine is confined to ocular thera- 
peutics. For ophthalmic purposes, gr. ij-iv may be dissolved 
in water, foj- (On Duboisia, Norris, Ringer, Seely, Wecker and 
Bancroft.) 

The Mydriatic Alkaloids of the Solanaceae, just described, 
will be here reconsidered, in order to make the statements 
relating to them the more easily understood ; they are atropine, 
daturine, hyoscyamine, hyoscine and duboisine. It is now gen- 

* Practitioner, November, 1886, p. 321. f Lancet, February 4th, 1888. 



NARCOTICS CANNABIS 1NDICA. 99 

erally admitted that they are all isomeric, having the formula 
Q7H23NO3, and, except hyoscine, are all clearly allied in physio- 
logical action. According to Prof. Wormley, atropine, daturine, 
hyoscyamine and duboisine respond similarly to the bromine 
and Vitali's tests. Hyoscine, found only in Hyoscyamus niger, 
is distinguished by possessing an hypnotic action, and in being 
an amorphous, brown liquid. Belladonnine is also an isomer of 
these alkaloids, but its effects have not yet been investigated. 
All possess basic properties, and, with acids, unite to form salts 
readily soluble in water; and, lastly, atropine, daturine — including 
hyoscyamine, duboisine and hyoscine — form, with gold, salts 
that have different fusing temperatures, which, in a measure, 
seem to distinguish them physically. 

It is owing chiefly to the investigations of Ladenburg that 
the exact chemical relations of these interesting principles have 
been elucidated. 



CANNABIS AMERICANA AMERICAN CANNABIS. 

CANNABIS INDICA INDIAN CANNABIS (FEMALE PLANT). 

Cannabis sativa, or Hemp {Nat. Ord. Urticaceae), is a native 
of Persia, and is cultivated in Europe and in the United States. 
Narcotic virtues were formerly thought to exist only in the 
C. Indica, or Indian variety of the plant, but recent investigation 
seems to show that the hemp plants raised in the Southern 
States, as Kentucky, are active, and might replace the East 
Indian drug. 

Gunjah is the dried compressed female flowers ; churrus is 
an impure resinous exudation, while bhang consists of the 
broken stalks and leaves made up with fruits ; it is known as 
hashish. 

C. Americana is the C. Sativa grown in the Southern United 
States and collected while flowering ; C. Indica is the flowering 
tops of the female plant of C. sativa grown in the East Indies. 
By evaporating a concentrated alcoholic solution of the latter, 
an Extract is obtained [extr actum cannabis Indica), which is 
the form usually employed. Extract of hemp -'is of a dark, olive- 
green color, a fragrant, narcotic odor, and a bitter, acrid taste. 
It is soluble in alcohol and ether, but not in water. The resin, 



IOO MATERIA MEDICA NEUROTICS 

which is the active principle (Roux *), has received the name of 
cannabin. A volatile oil has been isolated, decomposable into 
cannabene and cannabene hydride. Several alkaloids, it is claimed, 
have been discovered in small amounts, of which the principal 
are cannabinine and tetanocannabine ; the latter so named because 
it possesses tetanizing effects similar to strychnine. According 
to Jahns,f the only alkaloid existing in C. Indica is choline, and 
the principles termed cannabine and tetanocannabine are simply 
impure choline. 

Effects and Uses. — Indian hemp is not used locally. Nervous 
system : in medicinal doses it exerts a peculiar exhilarating effect 
upon the brain, the mental excitement induced by it being of an 
agreeable kind, and in this condition ideas flow readily, and con- 
ception of time is lost. Sometimes the delirium induced by hemp 
causes the individual to do deeds of violence, but it does not act 
upon all alike. One of the symptoms is a sense of weight about 
the extremities, accompanied by a loss of muscular power, and 
often a cataleptic state ; there is also cutaneous anaesthesia. 
Sleep follows the intoxicating effects of hemp, and the individual 
on awakening is unconscious of what has happened, but suffers 
from depression. It has no action upon respiration, circulation, or 
the secretions, but is said to increase the appetite, and aphro- 
disiac properties have been attributed to it. It is unknown how 
it is eliminated. Though lethal doses of hemp have produced 
alarming symptoms, there are no recorded fatal cases. It has 
been employed with success in chorea and hysteria, to relieve 
the pain of dysmenorrhea, especially when dependent on uterine 
fibroids, and for this end the extract (gr. j4) or tincture (tijj v) 
may be administered, and as an anodyne in rheumatism, gout, 
and neuralgia. In dysentery the tincture f^xv t. d. after meals 
is recommended (Rennie);J and ^v-x repeated, is very useful in 
dyspeptic diarrhoea, accompanied by defective action of the liver, 
in which the stools follow shortly after meals ; and in the ano- 
rexia succeeding the prolonged fevers. § It has also been given 
with advantage as an hypnotic in both mania and mania-a-potu ; 

* Bull. Gen. de Therap., 1886, CXI, p. 492. 

f Arch, der Pharm., 1 887, p. 479. 

% Indian Med. Gazette, Dec, 1886. 

\ The Practitioner, London, Feb., 1888, p. 95. J. F. P. McConnell. 



NARCOTICS — HOPS. IOI 

and its powers of exciting uterine contractions, and of checking 
uterine hemorrhage are highly spoken of. To aid the action on 
the uterus it may be combined with ergot. Dose, gr. ss-ij or 
more. A tincture (20 per cent, dose ^v-xxx) and a fluid extract 
(extr actum cannabis Indices fluidum) is also officinal ; dose, njjj-xv. 
As various samples of cannabis differ much in strength, it is 
better, when first using a new one, to begin with the minimum 
dose, to avoid unpleasant effects. 

HUMULUS HOPS. 

Hops are the strobiles of Humulus Lupulus, or Hop-vine 
(Nat. Ord. Urticaceae), a climbing vine, indigenous in Europe, 
and probably also in North America, with serrated, rough leaves 
and greenish-yellow flowers. The medicinal portion is the fruit, 
or strobiles, which are also largely employed in the preparation 
of malt liquors, and are known as hops. Near their base are two 
small, round, dark seeds, covered with aromatic glands or grains, 
which are the active portion of the hops, and are termed lupulin. 
They are separated by threshing, rubbing and sifting the scales, 
and constitute from a sixth to one-tenth part of the weight of 
hops. 

Lupulinum (Lupulin) is officinal, and when fresh is a brownish- 
yellow granular powder which has the aromatic odor and bitter 
taste of hops. Microscopically it consists of two hemispheres ; 
the lower somewhat conical, the upper top-shaped, and both 
reticulated ; within these is found a yellowish substance resemb- 
ling vegetable pollen. It is slightly soluble in water and is com- 
posed of a volatile oil, a bitter principle termed lupulite, resin, 
tannic acid and other matters. The scaly bracts contain a small 
portion of lupulinic matter. 

Effects and Uses. — Hops are tonic and feebly narcotic. The nar- 
cotic properties probably reside in the volatile oil, and the tonic 
properties in the bitter principle. They are said, also, to possess 
anaphrodisiac and astringent virtues, and sometimes prove 
diuretic. The odorous emanation is employed as an hypnotic 
by means of the hop-pillow. Internally, they are given to relieve 
restlessness, induce sleep, and prevent chordee (in form of lupu- 
lin), and are also employed for their stomachic and tonic effect. 
The combination of tonic and hypnotic virtues renders hops an 



102 MATERIA MEDICA NEUROTICS. 

excellent remedy in mild forms of mania-a-potu. Topically, they 
are employed in the form of fomentation or poultice, in painful 
swellings and tumors. As a soothing injection in vaginitis, and 
pruritus vaginae, hops Sj infused in boiling water Oij is recom- 
mended by AtthilL* Its efficiency is increased by the addition 
of borax 5j. 

Administration. — Hops are given in the form of infusion (not 
officinal — dose fSij— iv) and tincture (dose f5j— ilj). 

The best preparation for internal use is Lupulin, in the dose 
of gr. v-xij, in powder or pills. The fluid extract of lupuline 
may be used in doses of f5ss— ij. It is best given mixed with a 
little syrup and then largely diluted. The oleo-resin also is 
officinal ; dose, ""Kij— xxx. 

DULCAMARA. 

The young branches of Solanum Dulcamara, the Woody 
Nightshade, or Bittersweet {Nat. Ord. Solanaceae), a European 
vine, naturalized in the United States, possess combined nar- 
cotic and diaphoretic properties. The active principles are a 
poisonous alkaloid termed sola?tine (C 42 H 87 N0 15 ?), which has been 
found also in S. tuberosum, or common potato, and S. nigrum, 
or black nightshade, and a glucoside, dulcamarin (C22H 34 O 10 ). 

Effects and Uses. — In small doses the most obvious effects of 
bittersweet are an increase in the secretion from the skin and 
mucous surfaces, with some diminution of sensibility. Accord- 
ing to Eloy's f investigations it is hypnotic, analgesic, dilates 
the pupil, and in large doses induces vertigo and tinnitus 
aurium. In excessive doses it is an acro-narcotic poison. Its 
precise use is not obvious, but as an analgesic it might be ser- 
viceable in neuralgia. A fluid extract is officinal ; dose, foj, 
largely diluted. 



ORDER II. ETHEREAL ANAESTHETICS. 

The term Anaesthetics (from a, non, and atGO-qct?, sensation), 
properly speaking, includes all agents which diminish sensibility 
and relieve pain. It has, however, been used to denominate a 



* " Diseases Peculiar to Women," 7th ed., p. 26. 
f V Union Medicate, 1 886, p. 745. 



ETHEREAL ANESTHETICS ETHER. IO3 

class of ethereal remedies which are applied by inhalation, and 
produce such a condition of temporary insensibility as to pre- 
vent pain during surgical operations and parturition. 

The vapors usually employed to produce anaesthesia are those 
of ether and chloroform. Many other substances have, how- 
ever, lately been introduced as anaesthetics. 

ETHER ETHER. 

Ether is prepared by the distillation of alcohol and sulphuric 
acid, and is afterward rectified by redistillation with solution 
of potassa. For inhalation, however, it is further purified by 
being shaken with water, by which it is freed from alcohol, and 
this, as well as acid contaminations, are afterward removed by 
the agency of calcium chloride and freshly calcined lime. Thus 
purified, it is designated as ^Ether Fortior — Stronger Ether. 

Although commonly termed sulphuric ether, in allusion to 
the sulphuric acid used in its preparation, yet ether contains 
no sulphuric acid. By the action of the acid upon alcohol, 
ether is formed by the substitution of ethyl (C 2 H 5 ) for one atom 
of hydrogen in alcohol (C 2 H 5 HO), and is ethyl oxide (C 2 H 5 ) 2 0. 

Ether is a transparent, inflammable, colorless liquid, with a 
strong, fragrant odor and a hot, pungent taste. It wholly evapo- 
rates in the air, so rapidly as to cause a considerable degree of 
cold; combines with alcohol and chloroform in every proportion, 
and dissolves in ten times its volume of water. The specific 
gravity of pure ether is 0.7 1 3, of stronger ether (consisting of about 
94 per cent, of ethyl oxide and about 6 per cent, of alcohol 
containing a little water) 0.725, of ordinary officinal ether (about 
74 per cent, of ethyl oxide and about 26 per cent, of alcohol 
containing a little water) 0.750. The boiling-point of stronger 
ether is about 98 ° F. 

Effects and Uses when Swallowed. — When taken into the 
stomach, ether produces a primary stimulant and secondary 
narcotic effect, the stage of excitement being, however, very 
transient. Before the narcotic effects set in, the heart's beats 
are increased, the face is flushed, and the skin becomes moist. 
It has long been employed as an antispasmodic and anodyne 
remedy in asthma, angina pectoris, hysteria and cramp of the 
stomach and bowels ; and, from its combined stimulant and anti- 



104 MATERIA MEDICA NEUROTICS. 

spasmodic virtues, it has been found useful in the latter stages of 
typhus, attended by subsultus tendinum, etc. It has been ad- 
ministered to dissolve hepatic calculi, but its solvent virtues, after 
entering the blood, in this condition lack confirmation. In syn- 
cope, f 5ss or more, it is one of the best stimulants to restore the 
heart's action, and may be combined with brandy or whisky. 
As a topical anodyne, ether is a very good application in nervous 
headache and earache ; applied by means of an atomizer, it 
causes local anaesthesia; it has been also used as a cooling 
lotion in cerebral affections. The subcutaneous injection of ether 
is followed by pain and inflammation around the site of intro- 
duction, which usually subsides without suppuration. Thus 
administered, its systemic effects are more quickly produced 
than per or em. The deep injection is used in sciatica and to 
bring about reaction after hemorrhage, especially postpartum, 
and failure of cardiac action. If evaporation be repressed, when 
it is applied locally it acts as a rubefacient, and may be employed 
for counter-irritation. 

Dose, f5ss-j, to be increased when habitually used. It may 
be incorporated with water by rubbing it up with spermaceti, 
in the proportion of gr. ij to ether f5j, or it may be given in 
capsules of sugared gum. 

Effects and Uses when Inhaled. — The first effects of the inhala- 
tion of ether are a sense of strangulation and cough, from its 
local irritant action. When the vapor is absorbed into the 
system through the pulmonary surface, the nervous functions 
are successively and progressively affected. The mental facul- 
ties and volition become first impaired ; insensibility and uncon- 
sciousness rapidly supervene, during which susceptibility to pain 
is lost, and the patient lies in a trance-like sleep, resembling 
death. This condition is often preceded by one of excitement, 
during which patients sometimes weep, laugh, moan, sing, rave, 
or present pugnacious manifestations. In the beginning of 
etherization the circulation is accelerated, but it is afterward 
depressed. The period of full ether narcosis lasts from five 
to ten minutes, and the patient ordinarily recovers without 
serious inconvenience, although headache, nausea, drowsiness 
and languor sometimes ensue for a few hours. Occasionally, 
congestion of the brain or lungs, cataleptic rigidity with pro- 



ETHEREAL ANAESTHETICS ETHER. 105 

longed insensibility, and, in females, hysterical phenomena, 
ensue after etherization ; but these effects are uncommon, and 
it is believed that death has never followed the use of ether 
when care has been taken to admit atmospheric air into the 
lungs along with the ether. During the stage of insensibility, 
convulsive twitches or muscular rigidity are occasionally no- 
ticed ; the breathing is sometimes stertorous ; the iris becomes 
fixed; the pupils are dilated; the eyeballs are upturned; and the 
orbicularis palpebrarum does not contract when touched. In- 
sensibility to pain in some cases takes place before unconscious- 
ness ; and when patients are recovering from the latter state 
the mental faculties are often completely restored, while insensi- 
bility to pain continues. A brief period of anaesthesia, lasting 
less than a minute, has been noticed to occur before complete 
insensibility, which may be taken advantage of for short opera- 
tions. It has been shown by Flourens and Longet that when 
ether narcosis is fully established the functions of the nerve 
centres are involved in the following order, viz., the cerebrum, 
the sensory centres of the cord, the motor centres of the cord, the 
sensory centres of the medulla oblongata, and lastly, the motor 
centres of the medulla oblongata. The functions which continue 
to act are those presiding over circulation and respiration. 

Since the year 1842, the inhalation of ether — first resorted to 
in our own country by Dr. Crawford W. Long, of Athens, Ga., 
and shortly afterward by Morton, a dentist — has been practiced 
very generally in all parts of the world, with the greatest suc- 
cess, for the prevention of pain in surgical operations; and its use 
has been also extended, with the happiest results, to the relief 
of pain in labor. 

It should not be exhibited where disease of the heart or brain, 
or serious obstruction of the lungs, exists, or when from any 
cause there is unusual tendency to syncope, and precaution 
should be taken to guard against asphyxia ; but when adminis- 
tered with proper care and discrimination, it is attended with 
little or no danger or unpleasant results of any kind. Dr. 
Lyman* has, however, collected a number of fatal cases (37). 

The quantity of ether necessary to effect etherization is about 

* "Artificial Anaesthesia, etc.," 1881, p. 289. 



106 MATERIA MEDICA NEUROTICS. 

two ounces ; and it may be conveniently applied by means of a 
cone of stiff paper, shaped so that its base will fit over the nose 
and mouth of the patient, and into which a napkin or small towel, 
or hollowed-out sponge, is placed ; the sponge should be first 
soaked in warm water, squeezed dry, and saturated with pure 
ether. It is then applied to the mouth and nostrils, the mouth 
being permitted occasionally to receive atmospheric air ; and, if 
irritability of the air-passages occur, this is to be gradually over- 
come. From three to thirty minutes are required to produce 
anesthetization, and its occurrence is known by the closure of 
the eyelids (if they have been previously open), failure to respond 
to questions, and muscular relaxation. The sponge is then to 
be removed, and may be reapplied from time to time if neces- 
sary. 

Etherization is less apt to produce nausea if practiced upon an 
empty stomach, and the administration of a little brandy and 
laudanum promotes its action. 

To revive the respiratory movements when suspended by 
ether-narcosis, the agents that must be employed are artificial 
respiration, faradisation of the thoracic muscles, and inversion 
of the body according to Nelaton's plan. 

Etherization has been also resorted to in a variety of morbid 
conditions in which the administration of narcotics and antispas- 
modics has not proven potent enough. It exerts a powerful 
control over the violent types of spasmodic disease, and has 
been prescribed with advantage in hysteria, tetanus, strychnine 
poisoning, to prevent a paroxysm of asthma, chorea, convul- 
sions, puerperal eclampsia, to alleviate the pain of biliary and 
nephritic colic, as a relaxant in the diagnosis and reduction of 
dislocations, in the examination and setting of fractures, for taxis 
in hernia, the breaking up of adhesions, and in the diagnosis of 
feigned diseases. The extent to which etherization should be 
pushed varies, of course, with the nature of the disease and the 
acuteness of the pain. During the passage of calculi, for in- 
stance, it should be carried to the point of relieving the pain, 
while in dislocations complete anaesthesia is necessary. 

To relieve the pain of labor, complete narcosis should not be 
produced, as cessation of uterine contractions and loss of uterine 
retractility may result, leading to a delay in the delivery, reten- 



ETHEREAL ANESTHETICS CHLOROFORM. IO7 

tion of the placenta, and even post-partum hemorrhage. It 
should only be administered during the pains and intermitted 
between them, thus abating the suffering without abolishing 
voluntary efforts at expulsion. 

Instrumental or manual interference with labor may render 
complete anaesthesia necessary, or it may be desirable tempo- 
rarily to aid in the relaxation of a rigid cervix, or to prevent the 
woman from bearing down when the perinaeum is endangered 
by a too rapid delivery. 

Local anaesthesia and congelation may be produced through 
the agency of the ether spray applied to a part by the atomizer. 
(See pp. 66, 67, 104, 112.) 

CHLOROFORMUM CHLOROFORM. 

Chloroform is usually obtained from the distillation of alcohol 
with chlorinated lime, and, for medicinal use, 

Commercial Chloroform {Chloroformum Venule) (containing 
at least 98 per cent, of chloroform) is purified by agitation with 
one-fifth of its weight of sulphuric acid, which destroys the con- 
tamination of chlorinated pyrogenous oil ; and the sulphurous 
acid formed and the water present are afterward removed by 
means of a watery solution of sodium carbonate and of stronger 
alcohol and lime. The purest chloroform for internal use is 
now made from chloral hydrate. 

Purified Chloroform [Chloroformum Piiriftcatiini) is a color- 
less, volatile liquid, of a bland, ethereal odor and a hot, aromatic, 
saccharine taste. It is not inflammable, is slightly soluble in 
water and freely soluble in alcohol and ether. It has extensive 
solvent powers, dissolving camphor, the fixed and volatile oils, 
most resins and fats, iodine, bromine and the organic alkaloids. 
The purest chloroform has a specific gravity of 1.5022. Officinal 
chloroform has a specific gravity of 1. 485-1. 490 when it con- 
tains a little alcohol ; and as usually found its specific gravity is 
about 1.475, when it contains more alcohol, and is less apt to 
become acid. The boiling-point of pure alcohol is 142 F. It 
is chemically classed with the triatomic haloid ethers and is 
methenyl chloride (CHC1 3 V Chloroform is sometimes contami- 
nated with chlorinated pyrogenous oil (a very injurious impurity) ; 
this may be detected and removed by strong sulphuric acid, 



108 MATERIA MEDICA NEUROTICS. 

which gives the chloroform a color varying from yellowish to 
reddish-brown, according to the amount of impurity. The most 
delicate test for the presence of alcohol is iron binitro-sulphuret, 
which, when agitated with chloroform, will produce a brown tint 
if alcohol be present. 

Physiological Effects. — The effects of chloroform on the system 
are analogous to those of ether, but much more rapid and pow- 
erful. When inhaled, in the dose of a fluidrachm or more, 
it rapidly induces anaesthetic sleep, with great relaxation of the 
muscles, and the most complete insensibility to painful agents. 
The period at which insensibility occurs varies from fifteen 
seconds to two minutes, and it continues usually between five 
and ten minutes, and may be prolonged considerably by renewals 
of the inhalation. The patient usually recovers without recol- 
lection of what has occurred during the state of insensibility, 
and with few or no uncomfortable sequelae. Sensibility to pain 
is often very much obliterated even before consciousness is 
lost. 

The administration of chloroform has in many cases been 
attended with fatal syncope (Lyman * has collected 393 cases), 
due to heart paralysis. This has ordinarily occurred with such 
rapidity as to render remedial interference unavailable ; but at 
the slightest approach of symptoms of the kind, the patient 
should be placed in the recumbent position, cold affusions applied, 
and, above all, artificial respiration, together with electro-mag- 
netism to the respiratory muscles, the inverted position of 
Nelaton, and injections subcutaneously of ether or ammonia 
water, should be resorted to. 

Topically applied, and when its evaporation is prevented, 
chloroform acts as an irritant, and soon vesicates the skin — 
powerfully diminishing painful impressions during its appli- 
cation. 

Chloroform, like ether, should not be administered by inhala- 
tion to persons suffering from any serious disease of the brain 
or heart (especially fatty degeneration), or where any serious 
obstruction to the circulation exists. 

Medicinal Uses. — Chloroform is prescribed by the stomach as 

* "Artificial Anaesthesia, etc," 1881, p. 136. 



ETHEREAL ANESTHETICS — CHLOROFORM. IO9 

an anodyne and antispasmodic, in all cases to which ether is 
applicable, and has the advantage of a more agreeable taste. 
It has been found particularly useful to relieve the pain and 
vomiting of cancer of the stomach and also in intestinal colic 
and cholera. For diarrhoea and colic a good formula is — 
Ify Spiritus chloroformi, f 5ss ; tincturae capsici, f^v-x; mor- 
phinse sulphatis, gr. I /^\ aquae, f§ss. M. S. — One dose. Ex- 
ternally, it is used as a topical anodyne. The editor has used 
the deep injection of chloroform, n^x-xx, in sciatica, with good 
results — the injection being made over the nerve (B.). 

Dose, from ^xv to f5ss, in sweetened water or mucilage; to 
be repeated. As an anti-neuralgic liniment, f5j to f§ij of cam- 
phor liniment ; or as a rubefacient and anodyne, undiluted, on 
linen, covered with oiled silk, to prevent evaporation. As a 
wash or gargle, f5j or ij to water Oj. 

The introduction of chloroform as an anaesthetic — which prop- 
erty was first discovered by Sir James Y. Simpson — took place 
shortly after that of ether ; and from its greater intensity of 
action, its freedom from irritating effect on the bronchial mucous 
membrane, its more agreeable odor, and its non-inflammability, 
it has been extensively used, particularly in Great Britain, to 
the exclusion of 'ether. A very considerable number of fatal 
cases have, however, occurred from the inhalation of this agent, 
where its administration did not appear in any way contra-indi- 
cated ; and it cannot be considered a perfectly safe remedy. It 
is employed as an anaesthetic, anodyne and antispasmodic, to 
fulfill the indications to which ether is applicable. In labor 
chloroform should not be given until complete dilatation of the 
os has taken place, the head descending and the pains propul- 
sive. * It should be inhaled only when the pains come on, and 
there is no doubt! that its entire safety in obstetric practice is 
due to the intermittent plan of administering it. Its non-inflam- 
mability, too, in midwifery, should not be lost sight of. It is 
also used hypodermically ; dose, ^x-xx. 

The dose for inhalation is a fluidrachm, to be repeated in two 
minutes if anaesthesia be not produced ; and its effects may be 
renewed from time to time without injury.. It may be applied 

* Playfair, 5th ed., vol. I, p. 353. 



I 10 MATERIA MEDICA NEUROTICS. 

on a handkerchief, held near the nose or mouth, care being 
taken to allow a proper admixture of atmospheric air. 

A solution of chloroform in ether has been used in the United 
States, but, from the unequal volatilization of the two liquids, it 
must be difficult to modify their effects by combination. 

Spiritus Chloroformi {Spirit of Chloroform) is a solution of 
chloroform in alcohol ; a convenient form for internal exhibition. 
Dose, f5j. 

Linimentum Chloroformi {Chloroform Liniment) is made by 
mixing 40 parts of commercial chloroform with 60 parts of soap 
liniment. 

Mistura Chloroformi {Mixture of Chloroform) is made by 
mixing purified chloroform (8 parts), in which camphor (2 parts) 
is dissolved, with water (80 parts), by the intervention of fresh 
yolk of egg (10 parts). Dose, f5ss-j.* 

Since the discovery of the anaesthetic properties of ether and 
chloroform, many other substances have been employed for the 
purpose of anaesthesia. Of these may be mentioned — 

I. Methylene Bichloride. — This liquid, introduced to the 
profession by Dr. W. B. Richardson in 1867 (known also as 
dichloromethane) is most easily procured by the action of 
nascent hydrogen (developed from zinc, wa'ter, and sulphuric 
acid) upon chloroform. Its composition is CH 2 C1 2 . It is a 
colorless fluid, having a pleasant ethereal odor like that of chlo- 
roform, boils at 88° F., has sp. gr. 1.34, and mixes with ether 
and chloroform in all proportions. The vapor of methylene 
bichloride is pronounced by Mr. Spencer Wells to be the best 
known anaesthetic. Given properly diluted with air, according 
to his method (in an experience of more than a thousand cases), 
it has proved of uniform certainty and rapidity of effect, and free 

* Under the name of chlorodyne a combination containing chloroform is much 
used, for which the following is a formula: morphine hydrochlorate, 8 grains; oil of 
peppermint, 16 minims; stronger ether, a fluidounce; extract of liquorice, 2^ Troy 
ounces; pure chloroform, stronger alcohol, and molasses, each, 4 fluidounces; diluted 
hydrocyanic acid, 2 fluidounces; syrup, 17^ fluidounces; dissolve the morphine and 
oil in the alcohol, and add the chloroform and ether, mix the liquorice, syrup and 
molasses, shake the two mixtures, and add the hydrocyanic acid ; dose, 5 to 10 
minims, the vial to be well shaken. 

Numerous other formulae for chlorodyne have been published, but the above more 
nearly resembles the original preparation sold under this name. 



ETHEREAL ANAESTHETICS CHLOROFORM. Ill 

from any dangerous symptoms. It is used in abouf the same 
dose as chloroform, but has not been much employed in the 
United States. Nine fatal cases from its employment are re- 
corded.* 

II. Methylic Ether, made by digesting methylic alcohol 
with strong sulphuric acid, is a gaseous substance, lately em- 
ployed. Under the name of methyl-ethylic ether, it has been 
used, dissolved in ethylic ether, and is said to produce rapid 
anaesthesia, without spasm, syncope, or asphyxia during inhala- 
tion, or subsequent nausea. One or two drachms may be intro- 
duced into a bag inhaler, and the gas is volatilized by means of 
a hand bellows. 

III. Nitrous Oxide Gas, N 2 0, was the substance by which 
anaesthesia was in the first instance produced, in the hands of 
Mr. Horace Wells, a dentist of Hartford, Connecticut. It is 
made by the decomposition of ammonium nitrate by heat. It is 
a colorless, respirable gas, absorbable by water, and the solu- 
tion, like the gas itself, has a faint, agreeable odor and sweet 
taste. This gas is both a pleasant and efficient anaesthetic, more 
rapid and at the same time more transitory in its action than 
either ether or chloroform, and almost free from disagreeable 
or serious consequences. Lymanf has collected only four 
fatal cases which can be fairly attributed to nitrous oxide gas. 
During unconsciousness it causes considerable mental excite- 
ment, shown in various ways, as laughing, crying, etc., and 
lividity of the face. Buxton,! wno nas investigated its action, 
sums it up as follows : By trephining a dog and administering 
nitrous oxide gas, he observed the normal vermilion hue of the 
superficies change to purple, stasis within the vessels, and the 
brain substance to increase in size ; the cord viewed similarly 
was found also augmented in volume, so that some cerebro- 
spinal fluid was squeezed out. In both experiments the results 
obtained were the reverse of those induced by asphyxia, to 
which nitrous oxide unconsciousness has been attributed. 
Buxton considers its anaesthetic action due to its own inherent 



* Brit. Med.Journ., 1883, ii, 104. f "Artificial Anaesthesia, etc.," 1881. 

X Transactions of the Odontological Society of Great Britain, 1886-7, p. 90. On 
the Physiological Action of Nitrous Oxide Gas. 



112 MATERIA MEDICA NEUROTICS. 

sedative virtues, and as far as asphyxia is concerned seems to 
have proved his position. The heart's action and blood pressure 
are not much altered. The respiratory movements are primarily 
quickened, then slowed and finally extinguished — probably by 
paralysis of the centre. The heart continues to beat for a short 
time after the stoppage of respiration. Certain peculiar phe- 
nomena are occasionally encountered, as muscular rigidity fol- 
lowed by flaccidity, loss of the superficial reflexes, persistence of 
knee jerk, and less frequently involuntary evacuation of the 
bladder and rectum, and excitation of the sexual organs. It is 
well adapted to employment in the extraction of teeth, or in short 
minor surgical operations, but its effects are too transient for 
the anaesthesia required in protracted operations. The amount 
necessary to produce anaesthesia (one or two gallons), as well 
as the complicated apparatus required for its administration, 
constitute also an objection to its general use. It is best 
administered from an India-rubber bag, containing about eight 
gallons of the gas, furnished with a mouth-piece with two valves, 
one of which is designed for the throwing out of the respired gas. 
IV. Ethyl Bromide (C 2 H 5 Br) is an anaesthetic which a few 
years ago bid fair to supersede ether and chloroform, but the 
occurrence of several fatal cases under its administration led to 
the abandonment of its use, and it is now seldom resorted to. 
Ott* states that it destroys life either when inhaled or adminis- 
tered subcutaneously, by a toxic action on the respiratory centre. 

For the relief of pain during minor surgical operations, as the 
opening of abscesses or the extirpation of small tumors, local 
ancesthesia may be resorted to. This consists in congelation of 
the part by means of a freezing mixture (as ice and salt, which, 
when applied for three minutes to the integument, causes a 
thorough deadening of sensation in the superficial structures) ; 
or in spraying the part with some substance, as ether or ethyl 
bromide, which by its rapid evaporation produces the same 
effect; or the same purpose may be effected by the application 
of remedies like cocaine (a. v) or carbolic acid (q. v.), which 
depress the sensory nerves of the part to which they are applied, 
and thus deaden sensation. 

* " Bromide of Ethyl; its Toxicological Action." I. Ott, pamphlet. 



ANTISPASMODICS ASAFETIDA. II3 

ORDER III. ANTISPASMODICS. 

Antispasmodics are medicines that allay irregular nervous 
action. Their effects upon the economy in a state of health are 
not very decided, and are limited to a slight stimulation of the 
circulation and exhilaration of the mental faculties. Their 
influence is, however, strikingly shown in certain deranged 
conditions of the nervous system, particularly in those forms 
of spasm which depend upon idiopathic or primary nervous 
disorder, and are known under the designation of hysteria. 
They are also useful in many varieties of mental disturbance, 
as wakefulness, hypochondriasis, and even insanity, and are 
often preferable to narcotics in the treatment of these cases, 
from their comparative freedom of action on the brain. They 
are all distinguished by a powerful odor. 

ASAFGETIDA ASAFETIDA. 

Asafetida is a gum-resin obtained from the root of Ferula 
Narthex and Ferula Scorodosma {Nat. Ord. Umbelliferae), and 
is derived from Afghanistan. Though these are the sources 
given by the U. S. P., yet its exact commercial derivation has 
not yet been proven.* The plant has a long tapering root, the 
size of a man's leg, and an erect stem, from six to nine feet in 
height, rising from the midst of the leaves. The drug is obtained 
from incisions into the root, or by taking successive slices of it. 
The exuded juice is scraped off, hardened in the sun, and 
afterward packed for exportation. It occurs in masses of 
varying size, consistence, and color but is usually whitish, 
intermixed with darker spots, and becomes reddish, and finally 
brown, by exposure to the air. It is sometimes soft and 
adhesive, at other times hard and brittle, and is not readily 
powdered except at a low temperature. It breaks with a waxy 
lustre, and the best samples appear to be composed of irregularly- 
shaped tears. Its taste is unpleasant, bitter, and acrid ; its odor 
powerful, alliaceous, and fetid. 

Asafetida is a gum-resin united to an alliaceous volatile oil. 
The gum is dissolved by water, and the mucilage thus formed 
suspends the resin and volatile oil. The resin and volatile oil 

* Pharmacographia, 2d ed., p. 314. 



I 14 MATERIA MEDICA NEUROTICS. 

are soluble in alcohol ; but the tincture becomes milky on the 
addition of water, owing to the separation of the resin. The 
resin contains ferulaic acid (C 10 H 10 O 4 ) and umbelliferon (C 9 H 6 3 ), 
and, when fused with potassa, yields resorcin. 

Physiological Effects. — Asafetida, when taken into the stomach, 
produces a local stimulant and carminative effect. After 
absorption, it proves a moderate excitant and exhilarant, 
and exerts a marked antispasmodic influence upon morbid 
conditions of the nervous system. Large doses cause nausea 
and vomiting. It also stimulates the mucous secretions gener- 
ally, and increases the peristaltic action of the bowels, inducing 
soft, offensive stools. Its volatile oil is absorbed, and the 
odorous principle is recognized in the secretions, especially in 
the perspiration. 

Medicinal Uses. — No medicine used to be more highly es- 
teemed as an antispasmodic than asafetida, but it is now not often 
employed, because more efficacious and less disagreeable remedies 
have superseded it. It is resorted to in the various forms of hys- 
teria, and is valuable in relieving the mental depression which 
constitutes one of the protean types of this disorder. In other 
spasmodic diseases, as chorea, asthma and whooping-cough, it 
is a favorite remedy with many practitioners ; and, from its 
expectorant properties, it is useful in bronchitis. In certain 
affections of the abdominal viscera, as flatulent colic and 
costiveness, asafetida is often useful as an antispasmodic and 
laxative enema. In flatulent colic occurring in children, the 
mixture in doses of foj will generally give speedy relief. In 
tympanites, especially in hysterical patients or when accom- 
panying constipation, nothing proves more serviceable than 
enemata of the mixture, or suppositories (containing the equiva- 
lent of f^xl of the tincture). Enemata of the mixture have 
been used for the tympanites occurring in typhoid fever, but 
from the laxative effects of asafetida, turpentine is to be preferred 
in these cases. It is also prescribed as a stimulating emmena- 
gogue when the uterine disorder is attended with a disturbance 
of the nervous functions. 

Notwithstanding its disagreeable odor, this drug is largely 
used as a condiment in Asia; and even in the refined cookery 
of Europe its flavor is admired. Many persons take it habitually 



ANTISPASMODICS AMMONIAC. I I 5 

for its exhilarant effects ; and, when used as a medicine, it 
generally becomes acceptable. 

Administration. — Dose, gr. v to xx, in gelatine capsules. It is 
most frequently given in the form of mixture (mistura asafcetidcs, 
— 4 parts to water 100 parts) — dose fSss-j, repeated, or as an 
enema, fSij— iv. The mixture, from its whiteness and opacity, is 
sometimes called lac asafcetidcz, or milk of asafetida. Pills of 
asafetida are officinal, each pill containing gr. iij of the gum-resin. 
The tincture (20 parts to 100 of the tincture — dose, foj) is a good 
preparation, where the alcohol is not objectionable. A plaster is 
used externally in whooping-cough and bronchial catarrh ; it 
contains galbanum. Pills of aloes and asafetida and mixture of 
magnesia and asafetida (Dewees' carminative) are also officinal. 
The latter contains magnesium carbonate (5 parts), tincture of 
asafetida (7 parts), tincture of opium (1 part), sugar (10 parts), 
and distilled water (q. s. to make 100 parts) ; dose, f3j-iv. 

GALBANUM. 

Galbanum is a gum-resin obtained from Ferula galbaniflua 
and other species of Ferula (Nat. Ord. Umbelliferse), which 
grows in Persia. It is met with in the form of tears, or more 
commonly in lumps, of a brownish color, and has a peculiar 
balsamic odor and a hot, bitter, acrid taste. It is a gum-resin 
united to a volatile oil. From the resin are obtained umbel- 
liferon and resorcin. Its effects are similar to those of asafetida, 
but less active ; and it is chiefly employed externally, for its 
rubefacient properties, as a stimulant. The compound pills of 
galbanum are used as antispasmodic and emmenagogue ; they 
contain galbanum, myrrh, and asafetida, with a little syrup — 
dose, 3 to 5 pills. Galbanum forms the basis of the galbanum 
plaster, which contains galbanum, turpentine, Burgundy pitch, 
and lead plaster. 

AMMONIACUM AMMONIAC. 

This is a spontaneous gum-resinous exudation obtained from 
Dorema ammoniacum (Nat. Ord. Umbelliferse), a plant of Persia. 
It comes in tears or lumps, of an irregular shape, yellowish on 
the outside, whitish within, is moderately hard and brittle, and 
has an unpleasant, bitter, and rather acrid taste, with a peculiar 



Il6 MATERIA MEDICA NEUROTICS. 

smell, somewhat like that of galbanum. It is a gum-resin, with 
a little volatile oil, the latter free from sulphur. Resorcin, but no 
umbelliferon, is obtained from the resin. Its effects are similar 
to those of asafetida; but it is seldom used except as an anti- 
spasmodic expectorant in chronic bronchitis. Dose, gr. x to 
xxx. A mixture, 4 parts to water 100 parts, and plaster are offi- 
cinal. The plaster is made with ammoniac and acetic acid. A 
plaster of ammoniac with mercury is also officinal. 

CAMPHORA CAMPHOR. 

Camphor is a stearopten derived from Camphora Cinnamo- 
mum, the Camphor-Laurel {Nat. Ord. Lauracese), a large ever- 
green tree of China, Japan, and the island of Formosa. All 
parts of the tree are strongly impregnated with camphor, which 
is obtained from the chips of the roots and branches by sub- 
liming them with water and collecting the condensed camphor in 
pots. In this state it is known in commerce as crude camphor, 
and consists of dirty-grayish grains adhering in crumbling 
masses. Japan camphor (called also Dutch camphor, because 
introduced to commerce from Nagasaki by the Dutch colonists) 
has a pinkish color and is purer though coarser than the China 
camphor. The crude camphor, as imported from Canton and 
Japan, is not found in the shops until it is purified by resublima- 
tion with quick-lime, when it is termed refined camphor. This 
occurs in large hemispherical or convex-concave cakes perforated 
in the middle. It is solid at ordinary temperatures, soft and 
somewhat tough, but may be readily powdered by the addition 
of a few drops of alcohol, chloroform, ether, or equal weight of 
sugar. It is translucent, has a strong, fragrant odor, and an aro- 
matic, bitter, afterward cooling taste. It is volatile, highly inflam- 
mable, lighter than water, and very slightly soluble in it, but 
soluble in alcohol, ether, chloroform, oils and acids. Water 
added to the spirit of camphor precipitates the camphor. 

A valuable camphor* is known in the East, which is found in a 
concrete state in the cavities and fissures of the trunk of Dryo- 
balanops Camphora (Nat. Ord. Dipterocarpaceae), a tree of 

* Journ. of Pharmacy, xii, p. 22. On the Camphor of Sumatra; De Vriese. 



ANTISPASMODICS CAMPHOR. 11/ 

Borneo and Sumatra. By tapping the tree, or as a natural exu- 
dation, a camphor oil is obtained (DeVriese, loc. cit.), which must 
not be confounded with that of the laurel-camphor. 

The formula for camphor is C 10 H 16 O ; it is chemically nearly 
related to the terpenes (turpentine). Camphor forms substitution 
compounds with bromine, chlorine, and iodine, and yields an oil 
called oil of camphor, which drains away from the vats in the 
preparation of crude camphor. By passing hydrochloric acid 
into oil of turpentine, a substance is obtained called artificial 
camphor. Camphor heated with zinc chloride yields cymol 
(C 10 H 14 ), and with nitric acid, camphoric acid (C 10 H 16 O 4 ) and 
camphoronic acid (C 9 H 12 5 ), the last two being oxidation pro- 
ducts of camphor. 

Physiological Effects. — The topical action of camphor is irri- 
tant. After its absorption, its effects, in small doses, are moder- 
ately stimulant, exhilarant, and anodyne. In large doses, it 
causes considerable disorder of the cerebro-spinal system, de- 
pression of the circulation, and diaphoresis ; and in excessive 
quantity it acts as a narcoto-irritant, occasioning burning heat in 
the stomach, violent cerebral convulsions, and maniacal delirium. 
No deaths from camphor, however, have been reported in healthy 
adults. In small doses, gr. v, owing no doubt to stimulation of the 
circulation, it is aphrodisiac; in full doses, gr. xx, anaphrodisiac. 
Camphor is eliminated by the breath, skin, and urine, and it has 
been detected in the blood. In cases of poisoning, after evacu- 
ating the stomach, opium and wine are to be administered. 

Medicinal Uses. — From its combined antispasmodic and dia- 
phoretic powers, camphor is a valuable remedy in the treatment 
of dysentery and cholera, and is much employed in these diseases, 
either in combination with opium or as a substitute for the latter ; 
^ Spiritus camphorae, tinctura opii, aa ^x. M. S. — Every I or 2 
hours, in a little water. In the early stages of summer diarrhcea, it 
is also frequently prescribed, and for this purpose the spirit may be 
given gtt. x-xx, and repeated p. r. n. with paregoric. As a diapho- 
retic stimulant and antispasmodic, it is useful in the low stages of 
typhoid and typhus fevers, and in typhoid conditions of the sys- 
tem generally. In many forms of mental disorder it calms irri- 
tability, relieves despondency, and induces sleep. And it is useful 
as an anodyne in allaying irritation or pain of the genito-urinary 



Il8 MATERIA MED1CA NEUROTICS. 

organs, as in dysmenorrhcea, uterine after-pains, strangury, and 
nymphomania. In chordee large doses are required — gr. x-xx. 
Milton * considers f5ss-j of the spirit in water before retiring 
the best remedy for this complaint. He repeats the dose every 
time the patient awakes with chordee. On account of its pun- 
gency the administration of the fluid preparations is objectionable. 
Bumstead f gave it in pill, gr. iij- vj, at bed hour, combined with 
opium. Externally, camphor is employed as an anodyne in rheu- 
matism, and as a discutient in chronic inflammatory affections. 
Powdered camphor, sniffed into the nostrils, is a good remedy in 
coryza and influenza, or it may be volatilized in hot water and its 
fumes inhaled through a paper funnel ; it also enters into the 
composition of tooth-powders. 

Administration. — The medium dose in substance is gr. v— x ; 
but it may vary from gr. j to xx. It is best given in emulsion, 
made by rubbing up the camphor with loaf-sugar, gum arabic, 
myrrh and water. The form of pill is objectionable, from the 
difficulty with which it is dissolved in the gastric liquors. 

Aqua Camphors {Camphor-Water). Dose, f§j (containing 
about gr. ij) to f§ij or iij. The spirit is used chiefly as an embro- 
cation, but it may be given internally on a lump of sugar, where 
the action of alcohol is not objectionable, in the dose of gtt. v to 

f5j. 

Hope's Camphor Mixture consists of camphor water, fgviij ; 
nitrous acid, f5j ; laudanum, gtt. xxv; dose, f§ss, repeated. This 
preparation is an efficient remedy in the treatment of diarrhoea 
and dysentery. 

Linimentum Camphors {Camphor-Liniment) consists of cam- 
phor (20 parts) dissolved in cotton-seed oil (80 parts): a mild 
embrocation. 

Ceratum Camphors {Camphor- Cerate) is made by mixing 
camphor-liniment (3 parts) with olive oil (12 parts), and incor- 
porating the mixture with cerate (85 parts). 

Linimentum Saponis {Soap-Liniment) is made by digesting 
soap and camphor with oil of rosemary in alcohol and water. It 
is a yellow oleaginous liquid, and is used as an anodyne and 



On the Pathology and Treatment of Gonorrhoea," etc., 1887, p. 167. 
Pathol, and Treat, of Venereal Diseases," 1883, p. 91. 



ANTISPASMODICS VALERIAN. . I 19 

gentle rubefacient application in gouty and rheumatic pains, 
sprains, bruises, lumbago and myalgia. It is also frequently 
combined with other liniments, as those of chloroform or ammo- 
nia. 

Camphora Monobromata {Monobromated Camphor) is pre- 
pared by letting fall a stream of bromine upon powdered cam- 
phor till the latter is liquefied, then boiling the mixture in a 
water-bath, and afterward dissolving in alcohol and crystallizing. 
It occurs in long, colorless, acicular crystals (C 10 H 15 OBr), having 
an odor of camphor and turpentine and a slightly bitter taste, 
insoluble in water, but soluble in alcohol, fixed and volatile oils, 
ether, carbon bisulphide, and chloroform. It is a substitution 
compound, one atom of bromine taking the place of one atom 
of hydrogen in laurel-camphor. It has been used in delirium 
tremens and hysterical and convulsive affections ; dose for an 
adult, gr. v, repeated. 

VALERIANA VALERIAN. 

Valeriana officinalis, or Wild Valerian {Nat. Ord. Valerian- 
aceae), is a perennial European plant growing to the height of 
three or four feet. The rhizome and rootlets are the portions 
used, and consist of numerous brown, slender, brittle fibres, 
attached to a rough, yellowish-brown, tuberculated head. When 
powdered, it is yellowish- gray. It has a peculiar, powerful odor, 
of which cats are fond, and a bitterish, sub-acrid, aromatic taste. 
Water and alcohol extract its virtues, which depend on the 
presence of a volatile oil, and a colorless volatile acid, called 
valeria?iic, may be separated either from the oil or root. 

Effects and Uses. — The effect of valerian on the nervous system 
is not constant, for it is sometimes excitant, and again calming. 
The hypodermic injection of valerian oil reduces the reflex excita- 
bility of the spinal cord, and antagonizes in frogs the tetanic 
spasms of strychnine. In medicinal doses, valerian improves 
digestion and appetite. Large doses occasion eructations, colic 
and diarrhoea, excitement of the circulation, diaphoresis, and 
increased urinary flow. It is much used as a nervous excitant 
and antispasmodic in the various forms of hysteria, to control the 
active manifestations of which it may be prescribed with asa- 
fetida; ^ Tincturae Valerianae ammoniatae, tincturae asafcetidae, 



120 MATERIA MEDICA NEUROTICS. 

aa f5j. M. S. — One dose. Moral influence, however, in this 
unfortunate condition is mostly superior to medicine. Occa- 
sionally, also, it is given in epilepsy, chorea, hemicrania, hypo- 
chondriasis, and delirium tremens. 

Dose of the powder, from 5ss-jss, three or four times a day: 
of the abstract, gr. v-xv ; of the tincture (20 per cent, in diluted 
alcohol), f5j ; of the ammoniated tincture (20 per cent, in aromatic 
spirit of ammonia — an excellent preparation), f5j to ij ; of the 
fluid extract, foj ; of the oil, gtt. iv-v. 

Ammonii Valerianas (Ammonium Valerianate). — This salt, 
made by combining valerianic acid with ammonia, occurs in 
snow-white quadrangular plates, of an offensive odor like that- of 
valerianic acid, and a sharp, sweetish taste. It deliquesces in a 
moist air, effloresces in a dry one, and is very soluble in both 
water and alcohol. Potassa and the mineral acids decompose it. 
It is much employed in neuralgia, nervous headache, hysteria, 
chorea, epilepsy, etc. Dose, gr. ij-viij, given in coated pills; or 
an elixir, prepared with aromatics,* may be used. 

cypripedium. 

The rhizome and rootlets of Cypripedium pubescens and 
of Cypripedium parviflorum (Nat. Ord. Orchidaceae), common 
indigenous plants, known under the names of ladies' slipper and 
moccasin plant, are recognized by the U. S. Pharmacopoeia. 

The dried root is several inches long, bent, with a small, 
knotted, dark head, and numerous fibres of yellowish-brown 
color. It contains a volatile oil, volatile acid, and resin, and has 
been used as a substitute for valerian. Dose of the fluid extract 
(the only officinal preparation), ^x-xx. The powdered root 
may be given in doses of gr. xv, three times a day. An infu- 
sion and tincture are also used ; by precipitating the tincture with 
water, an oleo-resin is obtained, of which the dose is gr. ss-iij. 

SCUTELLARIA. 

The herb of Scutellaria laterifolia, or Skullcap (Nat. Ord. 
Labiatae), an indigenous perennial herb, found in moist localities, 

* Take of ammonium valerianate, £j ; fluid extract of vanilla, f^ss; cd. tinct. of 
cardamom, f 3 vj; curacoa, f^ ij; water, f^iv; mix. Dose, a teaspoonful three times 
a day. 



ANTISPASMODICS — COFFEE. 121 

growing to the height of one or two feet, is considered by many 
American practitioners to possess valuable antispasmodic quali- 
ties. A fluid extract is officinal. S. pilosoa and integrifolia have 
a more bitter taste, and have been used as tonics. 

The following vegetable substances, used as articles of diet, 
may be ranked also with antispasmodics : — 

I. Thea — Tea (not officinal), the dried leaves of Thea chinen- 
sis (Nat. Ord. Ternstromiaceae), an evergreen shrub of China and 
Japan, whence the markets of the world are supplied. The most 
important constituents of tea are essential oil (upon which the 
flavor depends), tannic acid, an alkaloid termed theine, discovered 
by Oudry, in 1827 — identical with caffeine, and boheic acid. 
According to Attfield * and others theine or caffeine is the 
alkaloid of tea, mate, guarana and kola nut. Dr. Mays f found 
it to be analgesic, and he has employed it, gr. y 1 ^— \, subcu- 
taneously for the relief of pain, though his experience was not 
entirely confirmed by Castle.J 

II. Caffea — Coffee (not officinal), the seed of Coffea ara- 
bica (Nat. Ord. Rubiaceae), a small tree which is a native of 
southern Arabia and Abyssinia, and is cultivated in various 
tropical and semi-tropical countries. Coffee contains an alka- 
loid, caffeine (C 8 H 10 N 4 O 2 .H 2 O) (which is methy-theobromine , iso- 
meric with theine), and two peculiar principles, one resembling 
tannin, termed caffeo-tannic acid, and the other termed caffeic 
acid. The volatile oil, upon which the flavor depends, is devel- 
oped by roasting. Coffee may be used for the general indica- 
tions of antispasmodics, and is, besides, especially efficacious in 
relieving the sopor produced by opium-poisoning. Both tea and 
coffee lessen the urea in the urine. Coffee is relaxing, while 
tea is astringent, since it contains tannin. Salivary digestion is 
retarded by tea, || in part owing to its tannin ; theine, caffeine or 
the volatile oil exert no action on it, while coffee and cocoa are 
indifferent. Gastric digestion is restrained by tea, coffee and 
cocoa, ranking in this order ; on pancreatic digestion they exert 
no influence. This kind of inhibition is not abnormal, as it con- 



* " Chemistry, Gen., Med. and Pharm.," 10th ed., p. 398. 

f Medical News, April, 1886. % Cinn. Lancet and Clinic, Jan., 1886. 

|| " Lectures on Dietetics and Dyspepsia," 1886, p. 28, et al. Wm. Roberts. 



122 MATERIA MEDICA NEUROTICS. 

tributes to a beneficial end, slow being quite different from 
imperfect digestion. 

Caffeina {caffeine). Gr. J^— iij produces decided cerebral 
effects, as excitement, wakefulness and hallucination, and, when 
exhaustion sets in, sopor. It increases the number of the heart's 
beats, and raises the arterial pressure, both being followed by- 
feeble action and diminished blood pressure. In frogs the motor 
and probably the sensory nerves are not affected by it. Injected 
into dogs and cats, it produces tetanus (Aubert). In cats * the 
increased flow of urine is coincident with dilatation of the blood 
vessels, and it augments the volume of the kidneys. Applied to 
a cut-out muscle, it causes rigidity (coagulates the myosin) and 
abolishes the electrical contractility. Caffeine elevates and then 
lowers the animal temperature, and has decided diuretic powers 
(Gubler). Its efficacy in diminishing the dropsy of cardiac and 
other affections, by increasing the urinary flow, has recently been 
investigated by Stahl,f who reports favorable results from its 
employment. In man, gr. viij-xij have caused decided cerebral 
effects, but no deaths have followed its use. Caffeine has been 
used as a cerebral stimulant in nervous headache (gr. j-ij), in 
cardiac dropsy (gr. v), and to antagonize morphine narcotism. 
Caffeine citrate is the salt most in use, and is also a powerful 
diuretic. Caffeine valerianate is useful in hysterical vomiting, in 
the dose of gr. j-ij repeated. None of the salts of this alkaloid 
are officinal. 

III. Theobroma — Chocolate (noticed more at length under 
the head of demulcents — see Oil of Theobroma) — contains a 
nitrogenous principle, theobromine, nearly identical in composi- 
tion with caffeine (C 7 H 8 N 4 2 ). 

IV. Erythroxylon — Coca or Cuca. — The leaves of E. Coca 
[Nat. Ord. Erythroxylaceae) have long been used as a masti- 
catory by the Indians in Peru for the purpose of enabling them 
to undergo fatigue, hunger and thirst. An alkaloid termed 
cocaine (C 17 H2lN0 4 ) has been found in coca, also cocatannic acid, 
which yields with the iron salts a green precipitate. Hydro- 
chloric acid is also incompatible, as it splits cocaine into methylic 

* Joum. of Physiol., 1 887, VIII, p. 1 17. Experiments by Phillips and Bradford. 
f "Inaug. Diss.," Wurzburg, 1887. 



ANTISPASMODICS — COCAINE. 1 2 3 

alcohol, benzoic acid and ecgonine. The most interesting effects 
of coca in man are cerebral stimulation, lessening of the feeling 
of fatigue, the ability to remain for a long time without food, 
increased cardiac action and elevation of temperature. Coca* 
lessens the excretion of urea and the urinary flow. Large doses 
cause muscular weakness, drowsiness and tinnitus aurium (Ott). 
Coca has been but little used in medicine, though its use is indi- 
cated in diseases requiring the checking of tissue waste, as 
phthisis. In cases of mental and physical fatigue dependent on 
overwork the wine or fluid extract repeated until the condition 
is relieved is a remedy of great value. The fluid extract is the 
best preparation ; dose, f5ss-ij. 

V. Cocaine (C 17 H 21 N0 4 ). — This alkaloid has attracted much 
attention, recently, from its power of producing local anaesthesia, 
which property, though first discovered by Professor von Anrep,f 
of Charkov, did not attract general attention until the publica- 
tion of a paper on the subject by Dr. Karl Koller, of Vienna, in 
September, 1884. The hydrochlorate, which is the salt in me- 
dicinal use, occurs in monoclinic prisms arranged in radial 
groups, soluble in alcohol and water. When sulphuric acid is 
added to the alkaloid or its salt, no change in color occurs, nor 
does the addition of potassium bichromate cause a variation. 
Phosphotungstic acid J produces a gelatinous white precipitate 
soluble in ammonia. The free alkaloid is very unstable, contact 
with water being sufficient to decompose it. Neutral solution of 
the hydrochlorate will keep for some time undecomposed. 

Effects. — A few drops of a four per cent, solution applied to the 
conjunctiva rapidly produces anaesthesia of that membrane and 
of the cornea (lasting from 10 to 20 minutes), with contraction 
of the vessels and anaemia of the membrane and dilated pupil, § 
preceded by slight contraction (which is gradual, the maximum 
being attained at the end of an hour); accommodation is said to 
be but little affected. Jackson affirms that cocaine influences 
unfavorably the nutrition of the cornea afterward. Applied to 
the mucous membranes of the mouth, nose, larynx and trachea, 

* Boston Med. and Surgical Journ., Sept. 7th, 1882. Mason. 
f Pflilgers Archiv., 1879, XXI > P- 3 8 - X Brit - Med. J., 1885, p. 479. Smith. 

\ " The Influence of Cocaine on the Pupil and Cornea." By Edward Jackson, 
M D. Trans. Coll. of Phys., 1 887, 165. 



124 MATERIA MEDICA — NEUROTICS. 

urethra, vagina and rectum, it allays irritation, causes a superficial 
and temporary anaesthesia, at the same time lowering the sensi- 
bility of the deeper tissues, contracting the vessels, producing 
anaemia of the surface (best seen in the vessels which ramify 
through the mucous membrane covering the turbinated bones 
in the nose) and lowering reflex sensibility of the part. Instilled 
into the external auditory meatus it causes a superficial diminution 
of sensibility without affecting the hearing, and lowers the tem- 
perature of this region. 

Dr. L. J. Tumas,* of St. Petersburg, found that a direct appli- 
cation of a few drops of yi to 4 per cent, solution, to the cerebral 
cortex of animals, caused a temporary fall of excitability of the 
portion painted ; and that if the cerebral cortex be painted during 
an epileptic seizure, the convulsions ceased. The dura mater was 
rendered insensitive in a few minutes by applying to it a solution 
of cocaine, and painting the femoral and sciatic nerves resulted 
in loss of sensation in the parts to which they were distributed. 
Intravejious injections, \ in dogs, caused general convulsions from 
irritation of the medulla, dyspnoea, reddening and swelling of the 
exposed brain, and diminution in the excitability of the psycho- 
motor. centres; the convulsive attacks were intermittent. 

The account here given of the internal action of cocaine is 
based chiefly on Mosso's J elaborate investigations upon dogs. 
Nervous system : in medicinal doses (in man) it stimulates the func- 
tional activity of the brain, the intellectual faculties becoming more 
active and imaginative, while the entire economy experiences a 
general feeling of renewed vigor. This state is succeeded by one 
of depression, and at the end by narcosis. Toxic amounts cause 
symptoms of general paralysis, abolition of sensibility, cessation 
of reflex action, cardiac weakness and stoppage of respiration. 
The irritability of the sensory nerves is destroyed, and, according 
to Ott, that of the motor nerves is much depressed. Skeletal 
muscles : it induces, in full doses, muscular contractions of the 
trunk and extremities by excitement of the motor tracts of the 
cord, the cranial ganglia not being involved. Section of the cord 

* Ejenedelnaia Klinitcheskaia Gazeta, Nos. 6 to 9, 1885. 

f Op. cit. Tumas. Also on cocaine, These pour le Doctorate en Medecine, Paris, 
1887, par Y. Duchesne. 

\ Arch fiir experiment. Pathol, u. Pharm., xviij, 1887, p. 153- 



ANTISPASMODICS COCAINE. 125 

between the occiput and atlas does not prevent this. A charac- 
teristic symptom of large doses is the production of sudden con- 
vulsions (not reflex) which resemble those of strychnia poisoning. 
On the involuntary muscles cocaine sets up also contractions, 
and, if the dose be large enough, the urine and faeces will be dis- 
charged involuntarily. According to Mosso the effects just noted 
are due altogether to an action on the nerve-centres, and not to 
one upon the muscle-substance, as is affirmed by Ott and others. 
Vulpian * found that cocaine caused wide pupillary dilatation. 
The patellar reflex is at first increased and afterward abolished. 

Circulation : cocaine increases the frequency and strength of 
the cardiac contractions, which are not dependent on paralysis of 
the vagi (Mosso). Anrep states, however, that the vagi are 
paralyzed, so that the matter cannot be considered as yet settled. 
A reduction of blood pressure succeeds full doses, which is fol- 
lowed by a rise, apparently due to a direct action on the vessels. 
The heart continues to beat after breathing has ceased. It stops 
the frog's heart in systole. Medium doses exert no influence on 
the vaso-motor centre or tonicity of the vessels. 

Respiration is increased, not by a reflex act, but by stimulation 
of the respiratory centre. A poisonous dose destroys life by 
paralysis of this centre. 

Temperature: grains ij injected into the jugular vein of a dog 
caused the rectal temperature to advance about 1°, which in toxic 
amounts is followed by a fall. 

Secretions : Vulpian (op. cit) could detect no increase in the 
hepatic, pancreatic, or salivary secretion, nor augmented flow 
through the ureters, but an increase in the sub-maxillary dis- 
charge was noted. As to the diuretic action of cocaine, Da 
Costa and C. B. Penrosef observed a decided increase in the quan- 
tity of urine and urates in nineteen out of twenty cases, with slight 
variations in sp.gr.; its influence on urea was not determined. 
They attributed its diuretic action to raised arterial tension. 
Elimination takes place, in part, by the kidneys, since it can be 
detected in the urine. 

The poisonous effects of cocaine are antagonized 'by chloroform 



* Compte Rendu, p. 836, 1884. 

f The Med. News, June, 1886. Observations on the diuretic influence of cocaine. 



126 MATERIA MEDICA NEUROTICS. 

and ether, which tend to arrest the tetanus of the respiratory 
muscles. Amyl nitrite also has been used successfully to antago- 
nize toxic doses of cocaine. After the immediate danger is 
passed chloral should be given, and to restore the breathing, arti- 
ficial respiration should be practiced. It is aided in action by 
alcohol, and the cerebral stimulants. 

Incompatibles : the alkaline hydrates and carbonates, throw 
down a white precipitate with solution of cocaine hydrochlorate. 

When administered hypo dermic ally it causes no irritation. If 
the injection be made into the superficial tissues it acts as a local 
anaesthetic, while a deep injection produces a slight, transitory, 
general lowering of sensibility, a rise in temperature of from 
o.5°-i.5° F., lasting several hours, dilated pupils with uncertain 
vision, and a stronger and fuller pulse, with increased power of 
the cardiac systole and lowering of the arterial tension. 

Uses. — It has been chiefly used locally, to prevent pain in ope- 
rations on the eye, nose, larynx, vagina, rectum, etc. For this 
purpose the part is painted or sprayed with a 2-4 per cent, solu- 
tion, and the application is renewed whenever the effect begins 
to wear off. In cases of photophobia, acute myringitis, painful 
deglutition (from tubercular or cancerous deposits in the pharynx 
or larynx), in vaginismus (to relieve the pain in order that an 
examination may be made, or previous to the sexual act), and in 
spasm of the rectum or anus due to fissure, it may be used with 
great benefit. In acute gonorrhoea, f5ij of a 4-10 per cent, 
solution may be injected into the urethra, a few minutes before 
urination, to prevent pain during that act. In irritable stricture, 
or irritability with spasm of the sphincter vesicae, a small gelatine 
bougie, containing gr. J^ of cocaine, has been passed down to the 
neck of the bladder and allowed to dissolve previous to a careful 
exploration of the urethra and bladder. A 20 per cent, solution 
has afforded relief in supra-orbital neuralgia, pruritus ani, and 
scrotal eczema, and has been used for the relief of pain during the 
operation for phimosis. It has also been applied to painful ulcers, 
either in powder or solution. 

It is also recommended to produce contraction of the vessels 
and diminution of swelling in mucous membranes of the nose 
and larynx, thus allowing the operator to obtain a better view of 
the parts during examination, or as a means of preventing copious 



ANTISPASMODICS COCAINE. 127 

hemorrhage during operations on the nasal mucous membrane, 
or to check epistaxis. 

Locally it has been applied, by brush or spray, to control hay 
fever, acute coryza, etc., and to lessen cough in laryngeal affections. 
Solution of cocaine hydrochlorate, 4-8 per cent, introduced within 
the nasal cavities by the atomizer is the best remedy to relieve 
temporarily the occlusion of the nasal fossae in acute and chronic 
rhinitis. Collections of inspissated mucus should be first washed 
away with Dobell's solution. In an elaborate article by Hern * on 
the use of cocaine in dental surgery, the following conclusions 
are reached, viz., that it cannot be relied on for the relief of pain 
after extraction, or to deaden the sensibility of dentine, and as an 
analgesic to exposed pulps it is of doubtful utility. As a submu- 
cous injection for the purpose of extraction it is inferior to nitrous 
oxide gas (summary of 90 cases). He considers it chiefly useful 
in the opening of abscesses, in the manipulation of models and 
instruments, and in operations on teeth with acute periostitis. 
Darier f states that it dilates the pupil without paralysis of 
accommodation, and is quite equal to atropine for the purpose 
of examining the fundus oculi. It has been used internally in 
gastro-intestinal neuroses, as gastrodynia, nervous dyspepsia, 
etc., in doses of gr. \-\ once or twice a day, in powder; to 
allay restlessness and produce sleep, in insomnia ; to check 
vomiting and diarrhoea in children ; in reflex vomiting gener- 
ally, as that due to sea- sickness or to pregnancy, and as a cardiac 
tonic in weak heart and nervous palpitation. Prof. Da Costa % 
has called attention to the successful use of cocaine hydrochlorate 
as a heart-sustaining agent in low fevers, especially where there is 
cerebral disturbance added. He gave gr. \-± 2 ever y two hours. 
Hypodermic ally it has been used to relieve pain in severe facial 
and other neuralgias, in acute pleurisy, and before the perform- 
ance of minor surgical operations, as the opening of abscesses, 
inflamed bursae, etc. 

When used for these purposes the needle of the syringe should 
not be inserted deeply, since superficial injections occasion local 

* Trans, of the Odontological Society of Great Britain, 1886-7, P- 218. Cocaine 
and its uses as a local anaesthetic in dental surgery. 

f Bulletin Gen, de Therapeutique, cvii. De l'emploi de cocaine en ThSrap. 
oculaire. % Pkila. Med. News, Feb. 5th. 1887, p. 302. 



128 MATERIA MEDICA NEUROTICS. 

anaesthesia; when thrown in deeply there is no loss of sensation 
of the superficies (DaCosta *). Injected into the skin of the epi- 
gastrium, it has relieved nausea and vomiting. Deep injections 
have been especially recommended when it is desirable to obtain 
the stimulating effects which the drug exerts over the heart, as in 
collapse, the early stages of shock, weak heart and low fevers. A 
few cases of death from very large doses have been reported ; one 
from gr. xxiv (Edes). 

Dose, internally, gr. J^-ss ; hypodermically, gr. %-%. 

VI. Guarana. — This occurs in chocolate-colored cylinders, 
which are worked up from the fruit of Paullinia sorbilis {Nat. 
Ord. Sapindaceae), a plant of Brazil, where it is used to make a 
common and highly-esteemed beverage. It contains more 
caffeine than any other vegetable substance, and also a variety of 
tannic acid. It is recommended, medicinally, as a tonic, astrin- 
gent, and antispasmodic, and has been found especially useful in 
sick headache; dose, 5j-ij, or an alcoholic extract may be given 
in doses of gr. x-xx. A tincture and fluid extract can be used. 
The latter is officinal and can be given in doses of *% x-xx, or 
more. 

VII. Mate. — Under this name the dried leaves of Ilex Para- 
guaiensis, a shrub of Paraguay, are extensively used in preparing 
a beverage throughout that region of country. Paraguay tea, as 
it is termed, has a balsamic odor and bitter taste, and contains a 
principle identical with caffeine and theine } and also tannic acid. 

MOSCHUS — MUSK. 
Class, Mammalia ; Order, Ruminantia. 

Musk is a peculiar dried secretion obtained from Moschus 
moschiferus, the Musk Deer, an animal rather larger than the 
goat, and resembling the deer in its characters, which inhabits the 
mountainous portions of central Asia. The musk bag is found 
only in the male, arid lies between the umbilicus and prepuce. 
It is an oval pod, about two and a half inches long and one and 
a half broad, flat on one side and convex and hairy on the other, 
and in a full-grown animal contains from 5jss to 5vj of a liquid 

* Trans. Coll. of Physicians, 1886, 39. Hypodermic use of hydrochlorate of 
cocaine. 



ANTISPASMODICS OIL OF AMBER. I 29 

secretion, which, when dried, is musk. Two kinds are known in 
commerce, the China and the Russia musk, the former of which 
is much the stronger. 

Musk occurs in grains or lumps concreted together, of a red- 
dish-brown color, and has usually some hairs of the pod mixed 
with it. It has a powerful, diffusive, aromatic odor and a bitterish 
taste. It is inflammable, leaving a light spongy charcoal. On 
analysis, it yields ammonia, fat, cholesterin, gelatinous and albumi- 
nous principles, but the odorous principle has not been isolated. 
It is partially soluble in water and alcohol, and completely so in 
ether. 

Owing to its high price, musk is greatly sophisticated. Some- 
times artificial pods are met with, which may be distinguished 
from the genuine by the absence of the remains of the penis, and 
of an aperture in the middle of the hairy coat. The musk itself 
is more frequently adulterated by mixture with dried blood and 
a variety of substances. Indeed, little if any genuine musk is 
found in the shops. 

Effects and Uses. — Musk is a powerful excitant and anti- 
spasmodic, without much effect on the cerebral functions. If a 
pure article could be obtained, it would have no superior as a 
direct antispasmodic in the treatment of essential nervous dis- 
orders — hysteria, epilepsy, chorea, and hiccough — and as a 
combined excitant and antispasmodic in the latter stages of 
typhus, and in typhoid pneumonia. But it is now little pre- 
scribed, owing to the difficulty of procuring it pure. 

Administration. — It may be given in the form of bolus or 
emulsion. Dose, gr. x, to be repeated every two or three hours. 
A tincture is officinal ; dose, f5j. 

An article termed Artificial Musk is made by the addition 
of one part of rectified oil of amber to three parts of nitric acid. 
It resembles musk both in sensible and medicinal properties, 
and it has been prescribed in its stead, in the same dose. 

OLEUM SUCCINI — -OIL OF AMBER. 

Amber, Succinum, derived from an extinct coniferous tree, 

Pinitis succinifer, is a fossil resin found in various parts of the 

world, and comes to this country from the shores of the Baltic. 

It is a hard, brittle substance, usually translucent, and of a pale 

9 



I3O MATERIA MEDICA — NEUROTICS. 

golden-yellow color, insipid and inodorous except when heated. 
By distillation it yields an oil, oil of amber {oleum succim), 
which, when rectified, is employed medicinally. The oil, solu- 
ble in alcohol, is nearly colorless at first, but gradually becomes 
brown, has a strong peculiar odor and a pungent acrid taste. 
An acid called succinic is also obtained from amber. 

Effects and Uses. — Topically, it is an active rubefacient. Oil 
of amber is excitant and antispasmodic, and has been used in 
hysteria, epilepsy, tetanus, pertussis, hiccough, and amenorrhcea. 
It is chiefly employed as an external application, and is a good 
remedy in pertussis and convulsions of children. Dose of the 
oil, gtt. v to xv, given in emulsion. For external use it may 
be mixed with three or four parts of olive oil and brandy, with 
one part of laudanum added. 

OLEUM iETHEREUM ETHEREAL OIL. 

This substance, known also as oil of wine, is made by the dis- 
tillation of alcohol with a large excess of sulphuric acid ; it is 
afterward mixed with an equal volume of stronger ether. It is a 
transparent, nearly colorless, volatile liquid, of a peculiar aro- 
matic ethereal odor and sharp bitter taste, sparingly soluble in 
water, but readily dissolved by alcohol or ether. Specific gravity 
0.910. It has antispasmodic properties, but is used in medicine 
only as an ingredient of the compound spirit of ether. 

SPIRITUS ^THERIS COMPOSITUS COMPOUND SPIRIT OF ETHER. 

This preparation, known as Hoffman's Anodyne, is a solution 
of ethereal oil (3 parts) in stronger ether (30 parts) and alcohol 
(67 parts). It is a colorless, volatile, inflammable liquid, having 
an aromatic ethereal odor, and a burning, slightly sweetish taste. 
It becomes milky on being mixed with water, owing to the pre- 
cipitation of the ethereal oil. 

Effects and Uses. — Hoffman's Anodyne has the antispasmodic 
and stimulant effects of ether, and derives additional tranquil- 
lizing and anodyne properties from the ethereal oil present ; it 
is also an efficient carminative. It is much used in hysteria, and 
is often added to laudanum to prevent the nausea which the 
latter sometimes excites. A good fever and tranquillizing 
draught is 3^ Spiritus aetheris compositi, f$j ; liquoris ammonii 



TONICS. I3I 

acetatis,tincturae opii camphoratae, aa fSss ; aquae, ad fSjss. M. S. 
— One dose. Shake before using. Dose, f3j-ij, in sweetened 
water. 

ORDER IV. TONICS. 

Tonics, called also corroborants, are medicines which produce 
a gradual and permanent increase of nervous vigor. It is only, 
however, in certain conditions of disease that they manifest this 
invigorating influence ; as, in a state of health, they often act as 
irritants or even nauseants. Their local effects are similar to 
their general effects. They exalt the nervous functions of the 
parts to which they are applied, and increase their firmness and 
density. When taken into the stomach they produce a twofold 
corroborant effect, improving the digestive powers by their local 
action, and strengthening the system generally by their cerebro- 
spinal influence. When given in very large doses, they produce 
nausea and vomiting, and when their administration is too long 
continued, they over-stimulate the gastric mucous follicles, 
causing a pathological secretion to be poured out, thus pro- 
ducing gastric catarrh. The after effect of tonics in large doses, 
especially of quinine, is one of depression upon the nervous 
centres. 

Tonics differ from stimulants only in the more permanent 
character of their effects. The more powerful tonics are closely 
allied to the narcotics in their action, producing, in overdoses, 
giddiness, loss of sight and of hearing, convulsions, delirium, 
and even death. And this analogy is further illustrated by the 
curative power of tonics in the relief of painful and spasmodic 
diseases, as neuralgia, rheumatism, chorea, and epilepsy. 

The articles of this class may be divided into vegetable and 
mineral tonics. The vegetable tonics are characterized by bitter- 
ness ; and it is said that they owe their bitterness and medicinal 
activity to a principle which has been termed bitter extractive. 
It is doubtful, however, whether any such proximate principle 
has really been obtained. They should be given before meals. 
The mineral tonics unite astringent with tonic properties ; and 
the preparations of iron produce a further corroborant effect by 
increasing the red coloring matter of the blood. 

The therapeutic application of tonics comprises a diversified 



132 MATERIA MEDICA NEUROTICS. 

range of diseases. They are employed as stomachics in dys- 
pepsia, and as general corroborants in convalescence from acute 
diseases, in chronic affections accompanied by marasmus and 
cachexia, in exhaustion and debility, in typhus and gangrene, 
and in typhoid conditions of the system generally. But their 
most striking and valuable powers are shown in their febrifuge 
influence upon miasmatic diseases. The modus operandi here 
is obscure, but the curative powers are undoubted, and have 
been attributed by some to their poisonous effects upon proto- 
plasm, thus destroying the germs on which these diseases 
depend ; while others believe they act by creating a powerful 
impression upon the central organs of the nervous system. The 
antineuralgic and antispasmodic properties of tonics have been 
already alluded to. They also enjoy considerable reputation in 
the treatment of chronic bowel-complaints, where they act by 
restoring tone to the debilitated intestinal tube ; and, on the 
other hand, they are often useful as laxatives in torpid conditions 
of the alimentary canal. 



VEGETABLE TONICS. 

The vegetable tonics may be arranged into three sections, 
viz.: 1. The pure bitters. 2. The aromatic bitters, which contain 
a stimulant volatile oil, and are aromatic as well as tonic. 3. 
The astringent bitters, which contain tannic and gallic acids, and 
are both astringent and tonic ; this group contains cinchona, 
the most powerful and important of the vegetable tonics. The 
bitter principle is also found in many medicines belonging to 
other classes, as rhubarb, aloes, taraxacum, etc., and imparts to 
them tonic properties. 

SIMPLE BITTERS. 
QUASSIA. 

Quassia is the wood of Picrsena excelsa (Nat. Ord. Simaru- 
baceae), a lofty tree of Jamaica and other West India islands. 
It is imported from the West Indies in billets of various sizes, 
which are found in the shops in the form of chips or raspings. 
It has no odor, but an intensely permanent bitter taste. Water 
and alcohol extract its virtues, which depend on a neutral 
principle termed quassin (C 10 H 12 O 3 ). 



TONICS GENTIAN. I 33 

The article originally known as quassia was the root and 
wood of Quassia amara, a shrub of Surinam, but this does not 
now reach our markets. 

Effects and Uses. — Quassia is a mild tonic, free from irritant 
or astringent effects, and is employed principally in dyspepsia, 
want of appetite, and* other stomachic affections. It promotes 
the appetite and digestion and causes a rapid development 
of strength. Quassin, given before meals in doses of gr. ss, 
increases the alvine discharge, and hence is useful in constipa- 
tion due to feebleness of the muscular tunic. In diarrhoea from 
relaxation of the muscles, it is also of advantage. It increases 
the saliva, milk, and secretions from the mucous membranes.* 
It is much used to give additional bitterness to malt liquors. 
It has proved a useful tonic in general debility, atonic dyspepsia, 
anorexia, chlorosis, and lingering convalescence especially after 
fevers. Dose, in powder (rarely used), gr. xx to 5j ; but the 
best form of administration is that of infusion, in doses of fSjss 
to iij ; the infusion is a good remedy for ascarides, given by 
injection. An extract (aqueous) is given in the dose of gr. v, but 
it is principally used as an excipient. A fluid extract is also 
officinal, dose ^v-xx. Of the tincture, ioo parts contain 10 
parts of the powder, the dose is foj to ij. 

GENTIANA GENTIAN. 

Gentian is the root of Gentiana lutea or Yellow Gentian 
{Nat. Ord. Gentianaceae), a perennial plant of the mountainous 
parts of central and southern Europe, growing to the height of 
two or three feet, with broad, ovate, opposite leaves and hand- 
some whorled yellow flowers. It is imported in cylindrical 
branched, twisted pieces, of various sizes, marked by transverse 
annular wrinkles and longitudinal furrows. Its odor in the 
fresh state is peculiar and disagreeable, but, when dried, feeble ; 
its taste is slightly sweetish and intensely bitter. Water and 
alcohol extract its virtues. It contains -a. fixed oil, an acid (geii- 
tisin or gentisic acid, Ci 4 H 10 O 5 ), pectin, grape-sugar, and a bitter 
principle termed gentiopicrin (C 20 H 30 O 12 ), a glucoside,. which is 
soluble in water and spirit of wine. Other species of gentian 

* Am. J. Phar. y 1883, p. 472. 



134 MATERIA MEDICA NEUROTICS. 

are employed as substitutes for the yellow gentian. The root 
contains no tannic matters (Maisch). 

Effects and Uses. — Gentian is a pure bitter, without either 
astringency or much aroma. In full doses it is more disposed 
to relax the bowels than the other simple bitters ; and, like 
others of the vegetable tonics, in excessive doses it is capable of 
producing narcotic effects. It is an admirable stomachic in all 
kinds of dyspepsia and gastric disorders, and is also used in the 
various forms of constitutional debility. In gastric dyspepsia, 
due to deficiency in the quantity of gastric juice, gentian com- 
bined with an alkali will relieve the condition. 1^ Tincturae 
gentianae compositae, f§j ; liquoris potassae, i^xv. M. S. — In a 
wine-glass of water before meals. 

Administration. — In the form of powder, rarely given on ac- 
count of its bitterness, the dose is gr. x to 5ss. Compound 
tincture (Tinctura gentiance composita, gentian 8 parts, bitter 
orange-peel 4 parts, cardamom 2 parts, to diluted alcohol 
enough to make the tincture weigh 100 parts), in the dose of 
f5j to ij ; extract {aqueous), in the dose of gr. x to 5ss ; and flidd 
extract, in the dose of f5ss-j. 

CALUMBA. 

Columba or Columbo is now generally ascribed by botanists 
to Jateorrhiza Calumba {Nat. Ord. Menispermaceae), designated 
by some writers still under the old name of cocculus palmatus, 
a climbing plant of Mozambique, on the southeastern coast of 
Africa. The root is the officinal portion, and is known in 
Africa under the name of Calumb. It consists of fleshy tubers, 
with numerous offsets, which are the portions used, the main 
root being too fibrous. They are found in the shops in thin, 
circular disks about 2 in. in diameter, externally of a brown, 
wrinkled appearance, and internally yellow. The odor is slightly 
aromatic, and the taste persistently bitter. Owing to the starch 
which is found in columbo, it is liable to be worm-eaten. It 
contains, besides a large proportion of starch, two bitter princi- 
ples, colombin (C 42 H 44 14 ) and berberine (C 2 oH 17 N0 4 ), columbic acid 
(C22H21O7), but no tannin. Water and alcohol take up its vir- 
tues ; and from its liability to attract moisture from the air, it 
should not be kept in the form of powder. 



TONICS CHIRATA. I 35 

Effects and Uses. — Columbo is a very agreeable demulcent 
tonic, particularly acceptable to the stomach, and hence well 
adapted to the convalescent stages of acute disorders of the 
bowels and of fevers. It is also a good preparation in the sick- 
ness of pregnant women, and is one of the best of the stom- 
achics in all cases where there is unusual delicacy of the stomach. 
In its native country it is much employed in the treatment of 
dysentery. 

Administration. — The dose of the powder is gr. x-xxx (rarely 
used). It may be given in the form of infusion (dose, f5j to 
ij), which should be used at once, as it is liable to spoil. Of 
the tincture (10 parts to ioo parts of tincture) foj to iv may be 
given. Of the fluid extract, the dose is f5ss-j. Columbo is 

Fig. q. 




JATEORRHIZA CALUMBA. 



often combined with aromatics, iron and alkalies, and is some- 
times added to purgative mixtures. 

Berberine (C^H^NOJ (not officinal), the alkaloid found in 
columbo, is widely diffused in the vegetable kingdom, and is 
obtained from numerous plants of the natural orders Berberacecz, 
MenispermacecE and Ranunculacece, as barberry, yellow-root, 
hydrastis, goldthread and others. It has been employed in the 
form of hydrochlorate and sulphate, as a tonic and febrifuge, 
in doses of gr. j-x. 

CHIRATA. 

Ophelia Chirata (Nat. Ord. Gentianaceae), an East Indian 
plant, has been introduced into European and American prac- 
tice under the name of Chirata, where it now ranks among the 
best simple bitters. The entire plant is officinal. Chirata 



136 



MATERIA MEDICA NEUROTICS. 



contains a peculiar bitter neutral substance, termed chiratin 
(C 26 H 48 13 ), and ophelic acid (C ls H2o0 10 ), which is amorphous ; in 
medicinal properties it resembles gentian, and may be used in 
the same way. Dose, of the fluid extract i^v-xx ; of the tincture 
*Kv-f5j. 

AROMATIC BITTERS. 
SERPENTARIA. 

The rhizome and rootlets of several species of Aristolochia 
are known under the name of Virginia Snakeroot. The most 
familiar is A. serpentaria (Nat. Ord. Aristolochiaceae), an herba- 

FlG. IO. 




SERPENTARIA. RHIZOME AND ROOTLETS. 



ceous, indigenous plant, with a perennial root, composed of 
numerous slender fibres, arising from a knotty, brown head. 
A. reticulata is a variety found in the southwestern States. 



TONICS — EUCALYPTUS. I 37 

Virginia snakeroot is found in the shops in tufts of long, 
slender, matted fibres attached to a knotty, rugged head. They 
are brittle, and of a yellowish-brown color. The odor is aro- 
matic and camphoraceous ; the taste somewhat pungent, bitter 
and aromatic. Water and alcohol extract its virtues, which 
depend on the presence of a volatile oil, a bitter principle, resins 
and tannin. The roots of A. reticulata are very commonly 
substituted for those of A. serpentaria, from which they differ 
only in the larger size of their fibres. They are quite equal to 
the latter, and are thought even to contain a larger proportion 
of volatile oil. 

Effects and Uses. — Virginia snakeroot is a combined stimu- 
lant and tonic, with diuretic or diaphoretic properties, according 
to the mode of its administration. In full doses it irritates the 
alimentary canal, causing nausea, eructations and colic. It is 
much used in the latter stages of fevers, and in other acute dis- 
eases, and is frequently combined with Peruvian bark in the 
treatment of intermittents. It may be administered in infusion 
(not officinal), dose fgj to ij, repeated. Of the tincture (10 parts 
in iqo parts of tincture) the dose is f 5j to ij ; of the fluid extract, 
f5ss-j. Huxhairis Tincture contains serpentaria. 

EUCALYPTUS. 

The leaves of the Eucalyptus globulus {Nat. Ord. Myrtaceae), 
a lofty tree of Australia, commonly known as the Blue Gum- 
Tree, are classed among the aromatic bitters. The leaves should 
be collected from rather old trees. When fresh they are more 
active than when dried. They owe their activity to a volatile oil, 
having the odor of oil of peppermint, which contains cymol 
(C 10 H l4 ), two terpenes, and eucalyptol (C 10 H 18 O) ; from eucalyptus 
are also obtained tannin, resin (crystallizable) and cerylic alcohol. 

Effects and Uses. — The oil possesses a decided destructive 
power upon infusoria, and locally is an irritant. Nervous sys- 
tem : large doses in animals produce muscular weakness, loss of 
reflex irritability, and finally death from centric paralysis (cord 
and medulla). These effects are preceded by a period of excite- 
ment. In small doses in man it causes mental activity and a 
feeling of well-being. Circulation and respiration are both 
accelerated by eucalyptus. Secretions: the ingestion of the 



I38 MATERIA MEDICA NEUROTICS. 

drug excites the salivary secretion, promotes the appetite, causes 
diaphoresis, and, by stimulating the intestinal secretion, induces 
soft stools. It decidedly increases the elimination of urea (Gim- 
bert). It is eliminated by the bronchial mucous membrane, 
kidneys and skin. 

Eucalyptus has been given with contradictory results in mias- 
matic fevers, in doses varying from 5j— iv of the dried leaves, or 
less of the fresh, but it is unlikely that it will ever supersede 
quinine as an anti-miasmatic. The fluid extract is officinal; dose, 
f5j in some aromatic water. 

Oleum eucalypti (commonly called eucalyptot) has proved effi- 
cient in bronchitis and whooping-cough; dose, gtt. v-x in cap- 
sules or emulsion. 

Eucalyptus may be used as a tonic in gastric catarrh and 
dyspepsia, and its employment in chronic vesical catarrh is 
recommended. Indeed, its best effects are obtained in chronic 
affections of the mucous membranes, be they pulmonary, gastric, 
or vesical, and its beneficial influence in these diseases is due to 
contact of the oil during elimination with the surface. The 
growth of plantations of eucalyptus in miasmatic districts has 
been found to diminish the spread of malaria. 

ANTHEMIS. 

Anthemis nobilis, or Chamomile {Nat. Ord. Compositae), is 
a small herbaceous, trailing European plant, cultivated exten- 
sively in both Europe and this country. The flower-heads 
are the portions used. They consist of small spheroids, with 
convex yellow disks which contain the aromatic properties, and 
numerous white, spreading rays. Chamomile flowers have a 
bitter, aromatic taste, probably due to authentic acid, and a 
strong, peculiar odor, both of which are imparted to water and 
alcohol. They contain a volatile oil, bitter principle, a little tannic 
acid, and resin, but no alkaloid has been obtained. 

Effects and Uses. — Chamomile, in small doses, is a mild, agree- 
able, aromatic tonic, and, in large doses, acts as an emetic. 
The cold infusion is much employed as a stomachic, and the 
hot infusion is given to aid the operation of emetics. The 
flowers, boiled in water, form a good fomentation to inflamed 
parts. The usual form of administration is the infusion. Dose, 



TONICS EUPATORIUM. 



139 



as a stomachic, f§ij, two or three times a day, cold; as an emetic, 
hot, ad libitum. 

Matricaria. The flower-heads of Matricaria chamomilla 
or German chamomile {Nat. Ord. Compositae), an annual Euro- 
pean plant, possess properties very similar to those of chamo- 
mile. They contain volatile oil, bitter extractive, tannin, and 
malates. They are not much employed in this country. 

EUPATORIUM. 

Eupatorium perfoliatum, Boneset, or Thoroughwort (Nat. 
Ord. Compositae), is a very common indigenous plant, growing 
in wet grounds in every part of the United States. It has 
numerous herbaceous stems, with long, narrow leaves, per- 



FlG. II. 










EUPATORIUM PERFOLIATUM. FLOWERING TOPS. 



forated by the stems. The leaves and flowering tops are the 
officinal portion. They have a faint odor, a strongly bitter taste, 
impart their virtues to water or alcohol, and contain a bitter 



I4-0 MATERIA MEDICA NEUROTICS. 

glucoside, called eupatorin; also gum, tannic acid, and a trace of 
volatile oil. In the leaves are found also resin, wax, and gallic 
acid.* E. teucrifolium, E. aromaticum, and other native species, 
are almost identical in their properties with E. perfoliatum. 

Effects and Uses. — Thoroughwort is a stimulant tonic, dia- 
phoretic and expectorant, and in large doses proves emetic and 
laxative. It is a good stomachic in dyspepsia, and, from its 
combined corroborant, expectorant, and diaphoretic properties, 
is an excellent remedy in epidemic influenza, and in the latter 
stages of pneumonia and bronchitis. It is used also with good 
effect in rheumatism, and in intermittent, remittent, and typhoid 
fevers. It may be given in infusion, f§ij of which may be taken 
cold, as a stomachic, three or four times a day, and in freer 
warm draughts as a diaphoretic; but the fluid extract is to be 
preferred; dose, f5j. 

ABSINTHIUM. 

The tops and leaves of Artemisia Absinthium, or Worm- 
wood [Nat. Ord. Composite), a European plant, naturalized in 
New England, are ranked among the aromatic bitters, but are 
not now much employed. They may be given in infusion. 

Wormwood contains an essential oil (chiefly absinthol), a bitter 
principle termed absinthin (C4oH 58 9 ), tannin, etc. According to 
Magnan,f absinthe given to animals in small doses induces brisk 
muscular contractions, while large amounts provoke attacks in 
which the animal falls in tonic and clonic convulsions, with ster- 
torous respiration, and involuntary fecal and urinary evacuation. 
The convulsions are not prevented by depriving the animal of 
its cerebral lobes. He points out, too, that absinthe-epilepsy 
" is a kind of intoxication " to which is added the phenomenon 
of epilepsy. The oil possesses powerful stimulant properties, in 
large doses producing epileptiform convulsions, and in lethal 
quantities (fSj^) is capable of causing poisonous symptoms. 
No'fatal cases have, however, been recorded. J A liqueur termed 
absinthe, containing the oil in question, is much used in France, 
with highly pernicious effects. It enters into the composition 
of vinum aromaticum. 

* Am. Journ. of Pharmacy, F. W. Franz, Analysis of the Leaves of E. perfolia- 
tum, Feb., 1888, p. 77. 

f Compte Rendu, 1869, p. 825. % Woodman and Tidy, 1882, p. 268. 



TONICS — CINCHONA. I4I 

MAGNOLIA. 

The barks of Magnolia glauca, Magnolia acuminata, and 
Magnolia tripetala {Nat. Ord. Magnoliaceae), indigenous trees 
remarkable for the beauty of their foliage and the size and 
fragrance of their flowers, are officinal, and rank with the aro- 
matic bitters. The barks (quilled, thin, and inodorous) of the 
trunk, branches, and root are alike officinal ; but those of the 
last are the most active. They contain a volatile oil, tannin, 
resins, and a crystallizable bitter principle (Lloyd*). An extract 
of the fruit of M. umbrella yields magnolin. The aromatic pro- 
perty is impaired by drying, and is lost when the barks are long 
kept. 

They are used as gentle stimulant tonics and diaphoretics, in 
the low stages of fever, rheumatism, etc. An infusion may be 
given, but the best solvent is diluted alcohol. 

CASCARILLA. 

This is the bark of Croton Eluteria {Nat. Ord. Euphor- 
biaceae), a small tree of the Bahamas and other West India 
islands. It occurs in the form of small, thin, quilled pieces, 
though sometimes in fragments, having a grayish, easily detached 
corky layer and an inner smooth surface. Its taste is warm and 
bitter. It yields its properties to alcohol, and partially to water ; 
and contains volatile oil, resin, a bitter crystalline principle called 
cascarillin, and some tannin. 

Effects and Uses. — Cascarilla is a very pleasant aromatic 
bitter, causing neither vomiting nor purging, and hence agree- 
ing very well with the stomach. It may be given in powder 
in the dose of gr. xx to 5ss ; but this is a less agreeable form 
than the infusion; dose, f§ij. 

ASTRINGENT BITTERS. 
CINCHONA. 

The name Cinchona (derived from the Countess of Chinchon, 
wife of a viceroy of Peru) is applied to the bark of different 
species of Cinchona {Nat. Ord. Rubiaceae, Cinchonese), large 
trees which grow in the mountainous regions of the western 

* " Drugs and Medicines of North America," Nos. 1 and 2, 1886. 



142 MATERIA MEDICA NEUROTICS. 

portions of South America, from the 22° of south latitude to 
about the io° of north latitude. Two principal varieties of 
cinchona- are known in commerce : Cinchona Flava ( Yellow 
Bark), called in commerce Calisaya Bark, derived from Cin- 
chona Calisaya; and Cinchona Rubra (Red Bark), derived 
from Cinchona succirubra. The Pharmacopoeia now recognizes, 
however, as officinal the barks of all species of the genus Cin- 
chona which contain at least three per cent, of the proper cin- 
chona alkaloids. It acknowledges the following species, viz. : 
C. officinalis, C. micrantha, C. calisaya, and C. ovata. 

Cinchona is brought to the United States from the Pacific 
ports of South America. It is obtained by stripping the trunks 
and branches of the Cinchona trees during the dry season, and 
is dried by exposure to the sun, during which process the 
smaller pieces usually become quilled. 

I. The Yellow or Calisaya Bark comes both in quilled and 
flat pieces. The former are from three or four inches to a foot 
and a half long, from a quarter of an inch to two or three 
inches in diameter, and of variable thickness. They have a 
brownish epidermis (with longitudinal wrinkles and transverse 
fissures), which possesses none of the virtues of the bark. The 
bark itself is one or two lines thick, compact, of a short, fibrous 
texture, and when broken presents shining points. The flat 
pieces, which are derived from the larger branches and trunk, 
are usually destitute of epidermis, are more roughly marked 
externally and are of a browner hue than the quilled pieces. 
They are also less compact, less bitter, and of less medicinal 
virtue. The yellow bark is distinguished from the other barks 
by its much more bitter taste ; its comparative freedom from 
astringency ; its brownish-yellow, somewhat orange color, which 
is still brighter in the powder ; and by containing a large propor- 
tion of quinine with very little cinchonine. 

2. The Red Bark usually comes in large, thick, flat pieces ; 
sometimes also in quills from half an inch to two inches in 
diameter. They are covered with a reddish-brown, rugged 
epidermis, beneath which is a dark-red, brittle and compact 
layer, the interior parts being woody and fibrous and of a lively 
brownish-red color. The taste of red bark is bitter and astrin- 
gent ; its odor not different from that of the other barks ; its 



TONICS CINCHONA. 1 43 

powder is reddish. It contains considerable quantities both of 
quinine and cinchonine. 

Pale Bark, called in commerce Loxa and Lima Bark, derived 
from C. condaminea and C. micrantha is no longer officinal. It 
comes in thin quills of a pale fawn-color. The pale barks 
contain a much larger proportion of cinchonine than of quinine ; 
and, from their yielding little of the latter alkaloid, have fallen 
into disuse in the United States. 

Under the name of Carthagena Barks, large quantities of 
very good bark have been imported from New Granada, and 
are now used in the manufacture of quinine, under the name of 
Colombian barks. Their percentage of alkaloids varies greatly. 

Within a few years, the cultivation of several varieties of 
cinchona trees has been successfully introduced into India, the 
islands of Ceylon and Java, and also into Jamaica, and the 
markets are now supplied with barks of very good quality from 
these sources. 

Chemical Constituents. — The most important constituents of 
cinchona are two alkaloid-principles, termed Quinina {Quinine) 
and Cinchonina (Cinchonine), which exist chiefly in combination 
with an acid called kinic (inert). These alkaloids are found in 
different proportions in the different barks, quinine being obtained 
from the yellow bark most abundantly, cinchonine from the pale 
bark, and the two principles in about equal proportions from the 
red bark. Two other valuable alkaloids, quinidine and cinchoni- 
dine, are found (also as kinates) most abundantly in the pale and 
Carthagena barks, but to a certain extent in all. By heat, the 
crystallizable alkaloids are converted into amorphous modifica- 
tions, as quinine into quinicine and cinchonine into cinchonicine; 
and other alkaloids, aricine, paricine, quinamine, and paytine, 
have been discovered in cinchona. Other principles found are 
cincho-tannic acid, coloring matter, kinovic acid, starch, fatty 
matter, and a trace of volatile oil. Gum is found in the pale 
bark, but not in the yellow or red bark. 

Quinine is obtained by heating the sulphate with an alkaline 
solution. Quinine Sulphas (Quinine" Sulphate) is prepared in 
the following manner : Powdered yellow bark is boiled in water 
acidulated with hydrochloric acid, by which the alkaloid is 
separated from its combination with kinic and other acids, to 



144 MATERIA MEDICA NEUROTICS. 

form a soluble hydrochlorate. By the addition of lime, this 
salt is decomposed, and quinine precipitated. The precipitate 
is washed with distilled water, and is separated from insoluble 
impurities by digestion in boiling alcohol, which is afterward 
distilled off. To the residual brown viscid mass, mixed with 
distilled water and heated to the boiling point, sulphuric acid is 
added, in quantity sufficient to dissolve the quinine. The liquor 
is then boiled with animal charcoal, filtered, and set aside to 
crystallize. The alkaloid quinine may be obtained in the form 
of fine crystalline needles of a silky lustre, but usually occurs as 
a loose white powder ; it is inodorous, very bitter, and alkaline. 
It (the hydrate) is soluble in 1670 parts of cold water and in 
773 parts of boiling water, in little more than its weight of 
absolute alcohol, in about 5 parts of chloroform, and in 25 parts 
of ether, and also in the fixed and volatile oils. It unites with 
acids to form salts, the most important of which is the officinal 
salt, the sulphate. Its composition is C20H24N2O2.3H2O. Quinine 
and its salts may be distinguished from all other vegetable alka- 
lies and their salts (excepting quinidine and quinicine) by forming 
an emerald-green precipitate when treated first with fresh chlo- 
rine-water and then with ammonia (Thalleioquin test, detects -5-^oT 
part, Fluckiger). Herapattis test is made by adding to quinine 
sulphate (gr. v) diluted acetic acid (f5j) with alcohol (f5ss) and 
tincture of iodine (8 drops), heating gently over a spirit-lamp 
till it forms a clear light-brown solution, when, as the liquor 
cools, right-angled, quadrate, rhombic crystals are deposited, 
which by reflected light appear of a copper-green color, resem- 
bling the elytra of Spanish flies. This precipitate, which is 
quinine iodosulphate (C^H^^C^SC^HJa), is termed Herapathite. 
Cinchonine is a white crystalline substance, less bitter than 
quinine, almost insoluble in cold water, very soluble in boiling 
alcohol, and slightly soluble in ether and the fixed and volatile 
oils. Its composition is C20H24N2O. It is distinguished from 
quinine by striking a white precipitate when chlorine-water and 
afterward ammonia are added ; with potassium ferrocyanide, a 
yellowish-white precipitate ensues. As cinchonine is but slightly 
soluble in ether, while quinine is soluble in that menstruum, the 
latter may by this means be readily separated from the former 
alkaloid. The medicinal properties of quinine and cinchonine 



TONICS CINCHONA. 145 

are analogous, and cinchonine sulphate is now officinal. Quini- 
dine is isomeric with quinine, but more crystallizable and less 
soluble in ether ; its salts strike a white precipitate with solution 
of potassium iodide. Cinclwnidine is isomeric with cinchonine. 
It is usually found mixed with quinidine, the mixture being 
known as commercial quinidine. The commercial quinidine sul- 
phate (which is more soluble in water and alcohol than quinine 
sulphate) may be used as a substitute for the latter salt. 

Incompatibles. — The alkalies and alkaline earths precipitate 
the alkaloidal principles of cinchona ; tannic acid, and the tinc- 
ture and compound solution of iodine, form with them insoluble 
compounds ; the ferric salts precipitate cincho-tannic acid ; solu- 
tion of potassium arsenite is also incompatible with infusions 
and decoctions of cinchona, as it forms a precipitate with 
them. 

Physiological Effects. — Locally, cinchona and its alkaloids act 
as irritants, and have, besides, a marked antiseptic effect, arrest- 
ing putrefaction and fermentation by a destructive influence 
upon fungi and infusoria.* As the physiological action of cin- 
chona depends on its contained alkaloids (chiefly quinine), the 
following account relates to the latter. Nervous system : quinine 
in medicinal doses stimulates the cerebral functions and increases 
the mental activity. Full doses (gr. xv-xx) induce a hyperaemic 
condition of the brain, the first indications of which are upon the 
special senses, especially that of hearing, which undergoes sub- 
jective noises, as ringing and roaring in the ears (tinnitus annum), 
with partial deafness, the latter rarely permanent ; amblyopia is 
an accompaniment, though less common. Doses of this size, 
continued, may produce a sense of fullness of the head, frontal 
headache and vertigo. Very large doses augment the above 
symptoms, accompanied by a slow, weak pulse, dilatation of the 
pupils, convulsions and stupor ; death in rare cases has followed 
quinine-poisoning, though immense doses of it have been taken 
with impunity. Quinine given to frogs reduces and finally 
abolishes the reflex excitability of the spinal cord. Its effect in 
this respect, on man, is as yet sub judice. Quinine given in 



* Arch, de Physiol. Norm, et Pathol., v, 1873, P- 3^9- L'action de la quinine sur 
les vibrioniens et sur les mouvements amiboides ; par Bochefontaine. 
10 



I46 MATERIA MEDICA NEUROTICS. 

doses of gr. x-xx, during labor, energizes the uterine contrac- 
tions. Circulation : in small doses quinine slightly accelerates 
the action of the heart; while large amounts (gr. xl-lx) decidedly 
retard its beats and force, and sometimes cause it to intermit, 
especially in children. This slowing occurs after section of the 
vagi, indicating a direct influence on its motor ganglia ; applied 
in solution to the cut-out heart it quickly stops its movements. 
The cinchona alkaloids are readily dissolved from the bark by 
contact with the gastric juice, and being diffusible and crystal- 
line, quickly osmose into the blood ; if, however, they pass into 
the small intestines from any cause, contact there with the alka- 
line fluids of that tube will precipitate them, and they will be 
discharged with the faeces. Upon the blood, quinine has several 
marked actions, as follows : both in health and inflammation it 
diminishes the number of white corpuscles, and retards their 
amoeboid movements (Binz) ; Schwalbe's investigations, how- 
ever, do not confirm those of Binz ; it hinders the carrying of 
oxygen to the tissues, and increases the proportion of red to 
white corpuscles (Cutler and Bradford). The absorption of 
quinine by the blood is aided by the carbon dioxide gas of that 
fluid. How it exists there is unknown. The production of 
acid in freshly-drawn blood is diminished by the addition of 
quinine-solution (Binz). Temperature : in small doses in health 
no influence upon the animal heat has been noted ; but in large 
amounts a moderate fall takes place (about y 2 ° F.). No complete 
explanation has as yet been given of this action, but it seems to 
be due to an interference with the oxidation processes in every 
part of the body. Secretions : cinchona stimulates the peptic 
glands, increasing their secretion and consequently the appetite 
and digestion, and, from the tannic acid which it contains, pro- 
duces a slightly astringent effect not belonging to the salts of 
its alkaloids. If given too long, or if the stomach and bowels 
are in an irritable condition, it is apt soon to produce nausea, 
vomiting, and even diarrhoea. Occasionally quinine causes a 
cutaneous eruption, as erythema, herpes, etc. A rare effect is 
renal and cystic irritation. Quinine, it is said, causes contrac- 
tion of the spleen (Piorry) ; this, however, has been denied. 
Large doses of quinine (gr. xxv-xl) decidedly diminish the 
amount of urea and uric acid in the urine, also the phosphoric 



TONICS CINCHONA. 1 47 

acid. Elimination * : quinine is eliminated chiefly by the kid- 
neys, and it has been found in the urine twenty minutes after 
the injection of a large dose. According to Thau from }4 to % 
escapes in the first six hours. It is discharged partly as quinine 
and partly as isomeric modifications (quinicine). 

Medicinal Uses. — Though the medicinal value of cinchona, or 
its alkaloid, quinine, can scarcely be over-estimated in the treat- 
ment of various diseases, yet its chief therapeutic applications 
can be divided into three classes, in the following order of merit : 
1. Antiperiodic; 2. Antipyretic; 3. Tonic. The most import- 
ant therapeutic employment of cinchona is as an antiperiodic 
in the treatment of fevers of a miasmatic origin. Its efficacy in 
these diseases was first made known to the world by the Jesuit 
missionaries in Peru, from whom it was called Jesuit's powder. 
As cinchona itself is now rarely administered internally, the fol- 
lowing remarks apply especially to its alkaloids, on which its 
powers depend. The type of miasmatic fever in which the 
effects of quinine are most strikingly displayed is intermittent, 
the non-pernicious and uncomplicated forms of which it rarely, 
if ever, fails to control. It may be given in these cases from the 
very onset of the attack ; and if, owing to gastric irritability, it 
is rejected by the stomach, it should be introduced by the rectum 
or by hypodermic injection. In remittent fevers, quinine is 
scarcely less useful than in intermittents ; and most physicians 
who practice in miasmatic districts now concur in recommending 
its early exhibition in these fevers, without waiting for a remis- 
sion. In either disease the best time, however, for its adminis- 
tration, since the major portion is eliminated in the first six 
hours, is from four to six hours preceding the paroxysm, and 
should it be desirable to get its effects quickly, on an empty 
stomach and in solution. In the pernicious or congestive forms 
of intermittent and remittent fevers, the early administration of 
large doses of quinine or cinchonine, in combination with stimu- 
lants, is imperatively demanded; and the hypodermic injections 
of quinine sulphate (gr. iij-v) may here be necessary. As a 
prophylactic against miasmatic fever, the use of the preparations 
of cinchona is very efficacious. We now seem to be approach- 

* Bull. Gen. de Thirap., t. xci. Rienzi. 



I48 MATERIA MEDICA NEUROTICS. 

ing an explanation as to the exciting cause of miasmatic fevers 
and the specific action of quinine against them, due to the 
researches of Marchiafava* and Celli on the plasmodium mala- 
riae; of Laveran,f on the microbes found by him in the blood; 
of Councilman and Abbott,J on certain hyaline bodies discov- 
ered by them also in the blood, and, lastly, to Osler,§ on the 
haematomonas malariae. These observers, with singular una- 
nimity, have found certain microbes in the blood of persons suf- 
fering with miasmatic fever, the vitality of which was destroyed 
by quinine. But it is yet too soon to formulate a positive theory 
which will surely connect the presence of these microbes with 
an attack of ague and the destructive action of quinine upon 
them. The antipyretic power which the quinine salts possess 
renders their use extremely valuable in conditions of pyrexia. 
In such states quinine is best given in a single large dose (5ss to 
5j), and since the elimination of the major portion of it takes 
place in the first six hours, it may be necessary to repeat this 
dose at the expiration of that time, if it be desirable to sustain 
its antipyretic effect. In Germany, the treatment of typhoid 
fever with large doses of quinine, gr. xx to xl, given in the even- 
ing, is in vogue. On account of the cardiac weakness, anorexia, 
and nervous depression produced by the salts of quinine, they 
should not be given in large doses in pneumonia.|| In erysipelas, 
the author has found quinine sulphate scarcely, if at all, less 
efficient than in miasmatic fevers, and it should be given gr. iij-v, 
t. d., frequently combined with large doses of iron (q. v.). In 
puerperal septicaemia, quinine may be given as an antipyretic in 
addition to antiseptic, uterine and vaginal injections, with digi- 
talis, as indicated, opium, stimulants and easily assimilated food. 
In all conditions of hyperpyrexia, as in acute rheumatism, the 
exanthemata and pyaemia, it is still employed, although the 
phenol-derivatives (e. g., antipyrin) are superseding it to reduce 



* Bull. d. r. Accad. Med. di Roma, 1886, xii, 19-22. Marchiafava E. Richerche 
sull'. infezione malaria. 

f Traite des Fievres Palustres, par A. Laveran, 1884, p. 448. 

% Am. J. M. S., April, 1884, p. 416. 

\ Brit. Med. Jour., March 1 2th, 1 887, p. 556. 

|| N. Y. Med. Rec, Jan. 29th, 1887. Discussion on the use of quinine in pneu- 
monia, N. V. Academy of Medicine. 



TONICS CINCHONA. 1 49 

temperature. As a general tonic and stomachic, cinchona and 
its alkaloids are also much used, but where gastric susceptibility 
exists, some of the simple bitters are preferable. In convales- 
cence from acute diseases, as the continued and eruptive fevers, 
in the hectic of phthisis, and in typhoid conditions generally, it 
is constantly prescribed. In the various neuralgise, a large dose 
of quinine combined with morphine or belladonna, or smaller 
doses with arsenic and iron, form an effective plan of treatment. 
By its contracting action on the gravid uterus, quinine sulphate 
exerts an influence in promoting normal labor, and will often 
prove useful in counteracting inertia of the uterus in parturition. 
A full dose of quinine will sometimes abort an impending par- 
oxysm of asthma. In surgical shock, as after grave operations, 
the administration of quinine is of the greatest utility. In acute 
inflammations, if the researches of Binz be correct, quinine in 
the first stage is the remedy to be employed in order to prevent 
the exudation of leucocytes, and for this object about gr. J^ to 
each pound of the patient's weight will be needed. The systemic 
effects of quinine may be obtained by introducing it within the 
rectum in suppository or enema ; but it is advisable only to so 
use it when its administration by the mouth is contra-indicated. 
Topically, cinchona is employed as an astringent and antiseptic. 

Administration. — The use of cinchona in powder has been 
almost abandoned, owing to its bulk and disagreeable taste. 
When exhibited in this form 5ss to jss is the dose as an anti- 
periodic given usually in divided amounts; as a tonic, 5j. The 
following officinal preparations are employed : infusion (6 parts 
of the powder to water ioo parts, to which aromatic sulphuric 
acid i part is added), dose, f5ij, repeated ; extract' (of yellow 
bark), dose, gr. x-xxx, equivalent to 5j of bark ; fluid extract 
(yellow), dose, f5j, equal to 5j of bark; tincture (20 parts yellow 
bark to a mixture of 10 parts of glycerin with sufficient alcohol 
and water to make 100 parts of the tincture), dose, f5j-iv; com- 
pound tincture \_Huxham y s~\ (containing red bark 10, bitter orange- 
peel 8, serpentaria 2, glycerin 10, alcohol and water to make 
100 parts of tincture), dose, f5j-iv. In prescribing bark, opium 
or port wine is often given with it, when it acts on the bowels. 
It is also occasionally combined with serpentaria, and when the 
stomach will not retain it, it may be administered by the rectum, 



150 MATERIA MEDICA NEUROTICS. 

or even the hypodermic exhibition of the quinine sulphate may be 
resorted to. When administered subcutaneously the danger of 
the formation of a small abscess at the seat of introduction must 
not be lost sight of, and a salt soluble in water should be 
selected, as the bisulphate, the solubility of which may be in- 
creased by the addition of tartaric acid. 

Quinine Sulphas {Quinine Sulphate). This salt is prepared 
by the process described at p. 143. It occurs in fine, silky, 
rather flexible needle-shaped crystals (interlaced among one 
another, or grouped in small star-like tufts), which are odorless, 
very bitter, and slightly efflorescent. It is soluble in 740 parts 
of cold and 30 parts of boiling water, readily soluble in alcohol, 
but insoluble in ether. Quinine is a ternary base, and forms, 
with sulphuric acid, a basic, normal and acid sirtpJiate. Basic 
quinine sidphate, 2(C 2 oH24N202)S0 4 H 2 + 7 aq., is the salt in com- 
mon use. By the addition of dilute sulphuric acid to the basic 
salt normal quinine sulphate (C^H^^C^.SO^Hg -f- 7 aq.) is ob- 
tained in four-sided prisms, which are soluble in 1 1 parts of cold 
water. Acid quinine sulphate (C^H^NaC^SC^Hg -f- 7 aq.) 
occurs as white prisms, freely soluble in water. Solutions of 
quinine and its salts possess the property of fluorescence and 
left rotatory power on polarized light. Quinine sulphate is 
decomposed by the alkalies, their carbonates and the alkaline 
earths. In solution it forms white precipitates with liquor 
potassae, sodse, and ammonise. The tannic acid of astringent 
infusions throws down a white compound, and the soluble lead 
salts, oxalic, tartaric and gallic acids yield a precipitate with 
it ; with compound solutions of iodine, quinine iodide is formed. 
Various substances are mixed as adulterations with quinine sul- 
phate. They may be detected by adverting to their relative 
solubility in different menstrua, as compared with the sulphate, 
or by chemical tests. Thus, gum and starch are left behind 
by alcohol ; salicin becomes red on contact with sulphuric 
acid, etc. 

Effects and Uses. — The effects of quinine sulphate on the sys- 
tem are the same as those of cinchona, and, from its being less 
apt to disagree with the stomach, it has almost superseded the 
use of the latter. See pp. 147, 149. 



TONICS CINCHONA. I 5 I 

Administration. — The ordinary dose of the quinine sulphate* 
as an antipyretic gr. x-xx, repeated as indicated, as an antipe- 
riodic, gr. xvj, equal to about §j °f bark, but as much as gr. 
xx, and even more, are often required ; as a general tonic, gr. 
j-vj. It may be given dissolved in some aromatic water, by the 
aid of aromatic sulphuric acid, also as an enema, or hypodermi- 
cally. (Glycerin is a good excipient for pills of quinine sulphate.) 
Saccharin will partly disguise the bitterness of quinine. 3^ Qui- 
ninse sulphatis, gr. j ; saccharin, gr. v ; aquae, fgj j£. M. S. — Shake. 

Quinine Bisulphas (Quinine Bisulphate\ the normal quinine 
sulphate, is preferred only on account of its greater solubility (i 
part to II of water), as it contains about one-third less of anhy- 
drous quinine than the basic sulphate. (See foot-note.) It may 
be given in the same doses as the ordinary sulphate. 

Many other salts of quinine have been introduced into practice, 
but few possess any advantage over the sulphate and bisulphate. 

Quininze Valerianas (Quinine Valerianate) is obtained by dis- 
solving freshly precipitated quinine in diluted valerianic acid. 
It occurs in transparent or white rhomboidal tables, of the 
peculiar repulsive odor of valerianic acid, and an acrid, bitter 
taste, soluble in alcohol and ether, and soluble in water (i to 
100). It fulfills the indications of quinine and valerianic acid, 
and is therefore especially useful in nervous disorders. Dose, 
gr. j to xx. Quinine liydrobr ornate is officinal, and being soluble 
in 1 6 parts of water, is recommended also for hypodermic use 
(Gubler). Quinine hydrochlorate is also officinal ; it is soluble in 
water I to 34 parts. 

Quinine sulphovinate, from its ready solubility, dissolving in 
twice its weight of water, is well adapted to hypodermic injection. 

Quinine carbolate, citrate, phosphate, salicylate, and sulpho- 
carbolate have all been used of late. 



* Therapeutical equivalents of the salts of quinine, by M. Boymond. Bull. Gen. de 
Therap., April 15th, 1887, p. 311. 

1.34 gramme of the basic sulphate = I gramme of anhydrous quinine. 

1.3 1 " " valerianate = " " " 

1.22 " " hydrochlorate = " " " 

I.30 " " hydrobromate = " " " 

1.69 " " bisulphate == " " " 
Others also are given. 



152 MATERIA MEDICA NEUROTICS. 

Crude quinine is the impure quinine obtained from the manu- 
facturer before separation from the insoluble impurities. It is a 
soft solid of resinous aspect, nearly free from bitterness, and 
may be given to children in the same doses as the sulphate. 

Chinoidinum (Chinoidin, qninoidiii) is a "mixture of alkaloids, 
mostly amorphous, obtained as a by-product in the manufacture 
of the crystallizable alkaloids from cinchona." (U. S. P.) It 
appears as a resinous mass, variable in quality, faintly bitter, of 
a brownish color, soluble in dilute sulphuric acid and alcohol, 
and, according to Liebig, bears the same relation to ordinary 
quinine that uncrystallizable sugar bears to the crystallizable. 
It is considered equally efficacious with quinine, but requires 
doses rather larger than quinine sulphate, than which it is much 
more economical. 

Cinchoxin.e Sulphas (Cinchonine Sulphate) is made from the 
mother-water remaining after the crystallization of quinine sul- 
phate. Being the most soluble of the sulphates of the four alka- 
loids found in bark, it remains in solution after the quinine 
sulphate and the mixed cinchonidine and quinidine sulphate 
have crystallized out. From the mother-water it is precipitated 
by solution of soda, then washed with alcohol, next re-converted 
into a sulphate, and boiled with animal charcoal to decolorize 
it. It occurs in short, oblique, shining prisms with dihedral 
summits, of a very bitter taste, more soluble in water (54 parts) 
than quinine sulphate, readily soluble by alcohol, and sparingly 
so by ether. It rotates polarized light to the right. By the 
addition of sulphuric acid it is converted into the more soluble 
neutral sulphate. It is now admitted to have the same remedial 
properties as quinine sulphate, but requires about one-third 
larger doses. Quinidine sulpliate and cinchonidine sidpliate * are 
now officinal ; both are soluble in water 1 to 100 parts. Their 
effects and uses are similar to those of quinine, as a substi- 
tute for which they are much used, but the dose is somewhat 
larger. 

* In an able article by J. Marty, entitled, " Contribution a l'etude du sulphate 
de cinchonidine envisage au point de vue physiologique et therapeutique," Bull. Gen. 
de Therap., cvi, pp. 395, 445, 1884, the following conclusions are drawn, viz., that 
its action varies greatly; that occasionally therapeutic doses may prove toxic; and 
that it should be used only in mild cases, and in doses double those of quinine. 



TONICS CORNUS. 



153 



CORNUS. 

Cornus florida, or Dogwood (Nat. Ord. Cornaceae), is an 
indigenous tree found in most parts of the United States, and 
growing in the Middle States to the height of from fifteen to 
twenty feet. Its flowers are remarkable for large four-leaved 
white or pinkish involucres, which appear with us in May. The 
officinal portion is the bark of the root. It occurs in pieces of 
various sizes, more or less rolled, and of a reddish-gray color. 



Fig. 12. 




CORNUS FLORIDA. INVOLUCRE. 



Its taste is bitter, astringent, and slightly aromatic. It yields its 
virtues to water and alcohol, and contains cornin (cornic acid), 
resin, tannic and gallic acids, etc. The barks of Cornus sericea, 
or swamp dogwood, and of Cornus circinata, or round-leaved 
dogwood, possess analogous properties. 

Effects and Uses. — Dogwood is deservedly esteemed the best 
substitute for cinchona among the native astringent bitters. It 



154 MATERIA MEDICA NEUROTICS. 

is somewhat irritant, and not unfrequently disorders the stomach. 
Dose, in powder, gr. xx to 5j ; of the fluid extract f5j or more. 

SALIX. 

The bark of Salix alba, the White Willow, and other spe- 
cies of Salix (Nat. Ord. Salicacese), is ranked among the astrin- 
gent bitters. It is little employed, however, except in the form 
of salicinum {salicin, C 13 H 18 7 , a glucoside) a neutral principle 
prepared from the bark of Salix' Helix and other species of 
Salix, consisting of white, slender, silky crystals, inodorous but 
very bitter, soluble in water and alcohol, but not in ether. 
Salicin produces effects similar to those of salicylic acid (q. v.), 
and is employed in the same therapeutic range, especially in 
acute rheumatism. It renders the sweat alkaline. Dose, gr. 
x-xx, frequently repeated. It has antiseptic and antifermentative 
properties ; it is not toxic. 

PRUNUS VIRGINIANA WILD-CHERRY. 

The Wild-cherry has long been known under the name of 
Prunus Virginiana, which is still retained by the Pharmaco- 
poeia. This name, however, belongs to another tree, the. choke- 
cherry ; and the wild-cherry is now properly distinguished as 
Prunus serotina {Nat. Ord. Rosaceae). The medicinal portion 
is the bark of the root and trunk, the former of which is the 
more active. It is found in the shops in pieces of various 
lengths and sizes, deprived of the epidermis and slightly curved, 
of a reddish-brown color and a bitter, slightly astringent, aro- 
matic taste. 

It contains a bitter, amorphous principle * (not isolated), resin, 
starch, tannic and gallic acids, a ferment-principle not identical 
with emulsin, and yields on distillation a volatile oil, containing 
hydrocyanic acid, which does not pre-exist in the bark, but is 
formed by the reaction in water of the bitter principle and the 
ferment. The leaves also yield this oil. Boiling water impairs 
the virtues of the bark. 

Effects and Uses. — Wild-cherry bark is tonic, with some astrin- 



* Pharma. Rundschau, Sept., 1887, p. 203, "On the Constituents of Wild Cherry 
Bark." Power and Weimar. 



TONICS PEPSIN. 155 

gency, and at the same time exercises a sedative influence on 
the nervous and circulatory systems, owing to the hydrocyanic 
acid which is developed in it. It is used with excellent effect as 
a sedative corroborant in the various forms of pulmonary irrita- 
tion, particularly in the latter stages of pneumonia and in the 
hectic of phthisis. It is also a useful stomachic and tonic in a 
variety of cases. The infusion (4 parts to cold water enough 
to make the infusion weigh 100 parts), is given in the dose of 
f§ij, twice or thrice daily. Of the fluid extract the dose is f 3j — Ij. 
Of the syrup, an agreeable preparation, the dose is fgss. 

DIGESTIVE FERMENTS. 
PEPSINUM PEPSIN. 

In connection with the subject of stomachic tonics, this article 
is entitled to brief mention. It is prepared from the rennets 
either of the calf, sheep or pig, taken from the animal as soon 
as killed, the best process being Scheffer's. The mucous mem- 
brane of well-cleaned, fresh hogs' stomachs is scraped off, 
chopped fine, and macerated for several days . in water acidu- 
lated with hydrochloric acid ; the strained and decanted clear 
liquid is mixed with a saturated solution of sodium chloride in 
water, and the separated pepsin after several hours is drained 
on a muslin strainer, and submitted to strong pressure. Pepsin, 
the ferment of the gastric juice, has the property, at 100 F. in 
an acid solution, of coagulating and dissolving albuminous prin- 
ciples. Two grains of pepsin, with an ounce of distilled water 
and ttjjv of hydrochloric acid, will dissolve 100 grs. of coagulated 
white of egg at 98 ° F. in about four hours. Of saccharated 
pepsin, " 1 part dissolved in 500 parts of water acidulated with 
7.5 parts of hydrochloric acid should digest at least 50 parts of 
hard-boiled egg-albumen at ioo° F. in five or six hours." 
Since alcohol impairs the digestive property of pepsin, prepa- 
rations of it in wine are unreliable. Acid solutions favor its 
action, especially hydrochloric acid, and it may be combined 
with this acid if deficiency of the gastric juice be suspected. 
Glycerin is the most reliable agent for preserving the ferment 
of pepsin (Liebreich). The alkalies and mineral salts precipi- 
tate pepsin from solution, and hence are incompatible. Pepsin 
is now a good deal used in dyspepsia and in diarrhoea, especially 



I56 MATERIA MEDICA NEUROTICS. 

that occurring in infants or children, where the stools contain 
undigested food. It may be given in doses of gr. v-xx after 
each meal, suspended in syrup of orange-peel to disguise its 
disagreeable taste, or taken on bread. Of saccJiarated pepsin, 
the dose is gr. v to xx ; of vinum pepsinae, f5ss-j, an inferior 
preparation. Liquor pepsini is a solution of saccharated pepsin 
(40 parts) in hydrochloric acid (12 parts), glycerin (400 parts), 
and water (548 parts) ; dose, foj-iv. It is probably more effi- 
cient in cases of children than of adults. When nourishment 
is to be given by the rectum (as when food is rejected by the 
stomach), the addition of pepsin and a little hydrochloric acid 
to animal broths for rectal injection is highly useful. Ingluvin 
is a preparation from the gizzard of the domestic fowl ; it is an 
aid to digestion, its action depending, probably, more on the 
bitter principle which it contains, and which stimulates the gas- 
tric glands, than to any digestive action of the preparation itself. 
It is recommended to allay various forms of reflex vomiting, 
especially the vomiting of pregnancy. Dose, gr. v-xv. 

PANCREATINUM PANCREATIN. 

This is obtained, by Mattison's process, from the pancreas of 
recently-killed animals, which is dissected and macerated in water 
acidulated with hydrochloric acid for about forty-eight hours, 
then separated, and the solution of pancreatin is passed through 
a pulp-filter until it is perfectly clear ; to this clear solution is 
then added a saturated solution of sodium chloride, and allowed 
to stand until the pancreatin is separated ; this is skimmed off, 
and placed upon a muslin filter and allowed to drain, after which 
it is washed with a less concentrated solution of sodium chloride, 
and then put under the press ; when all the salt solution is 
removed, and the mass is nearly dry, it is rubbed with sugar of 
milk, and dried without heat, after which it is diluted until ten 
grains emulsify two drachms of cod-liver oil. Saccharated pan- 
creatin is employed to promote the digestion of fatty matters, 
and may be administered in the form of emulsion, or dissolved in 
diluted alcohol or glycerin, or as a powder. As the activity of 
pancreatin is destroyed by acid, it should be given from 2 to 4 
hours after meals. It is a good addition to cod-liver oil. Dose, 
gr. v-x. It is not officinal. 



TONICS PREPARATIONS OF IRON. I 57 

PAPAYA. 

This is the dried juice of the half-ripe fruit of the Carica 
papaya {Nat. Ord. Papayacese), a white, slightly astringent pow- 
der, soluble in water, containing the ferment papain. This prin- 
ciple has the property of digesting albuminoids and converting 
them into soluble albumen. According to Finkler, its action is 
that of a ferment, and not one of solution. Dr. Herschell * 
ascertained that it acted alike in acid, alkaline or neutral fluids, 
and that it would dissolve IOOO times its weight of fresh blood- 
serum. Antiseptics, as carbolic or salicylic acids, do not hinder 
its action. It has no effect on starch (Martinf). It also dis- 
solves intestinal worms and the diphtheritic membrane. It is 
said not to retain its activity except in the dry state. Thera- 
peutically it is employed as an aid to digestion in the various 
forms of dyspepsia, to dissolve the diphtheritic membrane, and 
as ataeniacide. Prof. JacobiJ applies it to the diphtheritic mem- 
brane in glycerin, I part to 4 ; Schaffer uses it in water, strength 
5 per cent. — both frequently applied with a brush. The dose is 
about gr. j-v, to be taken after meals in powder, aqueous solu- 
tion, capsule, or compressed tablet. 

Further investigation and clinical experience are needed to 
place papaya on its proper therapeutical footing. 

MINERAL TONICS. 
FERRI PR^PARATA PREPARATIONS OF IRON. 

The preparations of iron (Ferrum), termed Ferruginea, Chaly- 
beates, and Martial preparations, are the most important of the 
mineral tonics. 

Physiological Effects. — Besides their local tonic-astringent effect, 
and their general corroborant action on the cerebro-spinal 
system, which they possess in common with the other mineral 
tonics, they exercise a restorative influence on the compo- 
sition of the blood, by increasing the number of its coloring 
particles and the amount of its solid constituents. Iron is in 
fact a natural constituent of the blood, and is to be considered 
as a nutrient rather than a medicine. The effects of the chaly- 

* Brit. Med. Journ., April, 1886, p. 640. 
f Journ. of Physiol., 1885, p. 336. % Therap. Gaz., 1886, p. 145. 



I58 MATERIA MEDICA — NEUROTICS. 

beates are best observed in conditions of the system in which 
there is a relative want of the red corpuscles of the blood. 
Under their use in such cases, while the digestive functions are 
promoted, the pulse becomes fuller and stronger, the skin as- 
sumes a healthy tint, the lips and cheeks become more florid, 
the temperature of the body is increased, and the muscular 
strength is greatly invigorated. On the other hand, the admin- 
istration of the ferruginous preparations in health, or too long 
continued, produces symptoms of plethora, vascular excitement, 
and a tendency to congestion and hemorrhage ; though, it may 
be doubted whether the blood will assimilate more than the 
normal proportion of iron. The iron salts stain the teeth a dark 
color, and possess an astringent taste. Taken with the food 
they assist the digestive process ; on an empty stomach, or when 
very large doses are taken, they irritate. 

The red corpuscles of the blood act as carriers of oxygen, 
which they take up from the inspired air in the lungs, and it is 
now believed that the iron in the blood-corpuscles converts 
oxygen into ozone, a more active form of this element. Iron is 
an essential constituent of hemoglobin, and observation has 
proven that a course of iron in anaemia increases the number of 
red corpuscles to double or treble (Robuteau). According to 
Cutler and Bradford this increase does not take place in health. 
The state in which it exists in the blood-corpuscles is un- 
known. Absorption : from the stomach it is thought to be 
absorbed as an albuminate. Metallic iron is oxidized, after inges- 
tion, by the help of water. The ferrous oxide and carbonate 
are rendered soluble by the hydrochloric acid of the gastric 
juice. Salts of the organic acids may be absorbed directly into 
the blood, the acidulous radical being burnt off and the basic 
iron remaining to combine with the red globules. Salts of the 
mineral acids, the nitrate, chloride, and sulphate, in doses not 
large enough to constringe the tissues, are absorbed without 
change. Secretions : the astringent preparations of iron, as the 
chloride, sulphate and nitrate, lessen the secretions generally, 
especially the gastro-intestinal. The excretion of urea is in- 
creased. The ferric salts possess more activity than the ferrous. 
Elimination : iron is eliminated by the bile, fseces and urine. 



TONICS PREPARATIONS OF IRON. I 59 

The faeces are, during a course of iron, of a dark color,, owing 
to the formation of ferrous sulphide. 

Medicinal Uses. — The diseases in which chalybeates are most 
serviceable are those which depend on a deficiency of the red 
corpuscles of the blood, as various forms of ancemia, particularly 
where this is connected with irregularity of the uterine functions, 
as in chlorosis. In these conditions it is best given in rapidly- 
increasing doses pushed until it causes headache, vertigo, fever 
or some gastric disturbance, and laxatives should be occasionally 
administered during a course of iron, to unload the portal cir- 
culation and relieve the constipation which usually ensues ; for 
the salts of iron after absorption pass directly through the liver, 
while any unabsorbed portion acts as an astringent upon the 
gastro-intestinal canal. After its effects are obtained the size of 
the dose can be regulated to suit the case. When anaemia is 
associated with gastric disturbance, the bitter tonics and acids 
are more serviceable than iron, which, however, may be given in 
the form of bitter wine of iron, as these symptoms subside. 
Iron is also frequently combined with arsenic in the treatment of 
anaemia and chlorosis : 3^ Acidi arseniosi, gr. j ; ferri reducti, 
gr. xxx ; oleoresinae capsici, gr. v. M. S. — Ft. pil. no. xxx ; one 
pill t. d., increased to five daily if the arsenic be well borne. By 
some authors * the slightly soluble preparations (iron filings, or 
reduced iron) are given at first, followed, if well borne, by the 
more soluble ones. Iron in any form does harm in chlorosis or 
anaemia accompanying the early stages of phthisis. f In the 
management of anaemia and chlorosis important adjuncts will 
be found in rare meats, rich broths and suitable stimulation. 
Iron is also useful in scrofula, tuberculosis, degeneration of the 
viscera, and cachectic states of the system, characterized by 
paleness of the lips, face and conjunctivae. Many forms of 
nervous disorders, as neuralgia, chorea, hysteria and epilepsy, 
are very decidedly controlled by the preparations of iron, and 
they probably constitute the best remedies in these affections, 
when attended with anaemia. Several of the preparations of 
iron are also much employed both as stomachics and astrin- 



* Trousseau et Pidoux, 9th ed., Vol. 1, 1880, p. 5. f Ibid., p. 7. 



l6o MATERIA MEDICA NEUROTICS. 

The following are the officinal preparations of iron, which are 
needlessly multiplied in the U. S. P. : — 

Ferrum Reductum [Reduced Iron). Metallic iron is obtained 
for medicinal purposes in the form of an impalpable powder 
by reducing- the ferric hydrate by passing a stream of hydrogen 
gas over it. It is a light, tasteless, iron-gray powder, insoluble 
in water, but completely soluble in diluted sulphuric acid, and 
it should be kept in a well-stoppered bottle, owing to its great 
liability to oxidation. This preparation, sometimes called Que- 
venne's Iron, is a mild chalybeate, and is a favorite prescription 
with many practitioners in the treatment of chlorosis and other 
varieties of anaemia. Dose, gr. v to x, three times a day, after 
meals, in the form of pill made with sugar and gum ; or it may 
be swallowed readily in a bolus of soft bread. It is sometimes 
prepared with chocolate in the form of lozenges. It is well 
adapted to prolonged use. 

Ferri Oxidum Hydratum (Hydrated Ferric Oxide). This 
preparation {ferric hydrate) (Fe 2 6HO) is made by precipitating 
the ferric hydrate from its combination in any ferric salt (offici- 
nally, ferric sulphate) by means of ammonia. When dry, it is a 
reddish-brown powder, and is not an eligible preparation for 
medicinal use. It is furnished in the form of a freshly-precipi- 
tated, soft, moist, reddish-brown magma for use as an antidote 
to arsenious acid. 

Ferri Oxidum Hydratum cum Magnesia (Hydrated Ferric 
Oxide with Magnesia). In this preparation ferric hydrate is pre- 
cipitated by means of magnesia, instead of ammonia. It is 
readily prepared, and is used as an antidote to arsenious acid. 
It is to be preferred to the ordinary hydrate, because the mag- 
nesia by its purgative action aids in the removal of any of the 
poison which may remain after the action of emetics or the use 
of the stomach pump. 

Ferri Carbonas Saccharatus (Saccharated Ferrous Carbo- 
nate) is obtained by the double reaction of ferrous sulphate and 
sodium bicarbonate, and is protected from oxidation by the addi- 
tion of sugar. It is a greenish-gray powder, oxidizing slowly 
in the air, only partially soluble in water, but completely soluble 
in hydrochloric acid. It is a valuable preparation, particularly 



TONICS PREPARATIONS OF IRON. l6l 

adapted to cases of weak digestion when iron is indicated. 
Dose, gr. v-xxx. 

Trochisci Ferri {Troches of Iron) are made with ferric hydrate, 
vanilla, sugar and mucilage of tragacanth ; each lozenge contains 
of the iron gr. v. 

Emplastrum Ferri {Plaster of Iron) is made with ferric hydrate, 
lead-plaster, Burgundy pitch, and Canada turpentine. 

Massa Ferri Carbonatis {Pill of Ferrous Carbonate) — Vallefs 
Ferruginous Mass. To protect the ferrous carbonate (FeC0 3 ) 
from oxidation, it is prepared (as in the process last described) 
by dissolving the reacting salts in weak syrup instead of water ; 
honey and sugar being afterward added to preserve it unaltered 
and bring it to the pilular consistence. This preparation is one 
of the most popular of the chalybeates. It contains nearly half 
its weight of ferrous carbonate. From gr. v-xx of the pilular 
mass may be taken in divided doses through the day. 

Mistura Ferri Cornposita {Compound Iron- Mixture) {Griffiths 
anti-hectic mixture) is a mixture of ferrous sulphate and potas- 
sium carbonate with myrrh, spirit of lavender, rose-water and 
sugar, to resist oxidation. It is a favorite chalybeate in chlorosis 
and amenorrhcea. Dose, f5j to ij, t. d. 

Pilules Ferri Composites {Compound Iron-Pills) are prepared 
with sodium carbonate and ferrous sulphate with myrrh and 
syrup. Dose, from two to six pills three times a day. Both 
these preparations should be made only as wanted for use. 

Ferri Sulphas [Ferrous Sulphate) (FeS0 4 .7H 2 0), known, in its 
impure state, as green vitriol or copperas, is prepared for medicinal 
use by dissolving iron wire in diluted sulphuric acid, with heat. 
It occurs in transparent, pale bluish-green crystals, of the form 
of oblique rhombic prisms, of an acrid, styptic taste, soluble in 
water, but insoluble in alcohol. By exposure to the air they 
effloresce, absorb oxygen, and become yellowish-white, from the 
formation of ferric sulphate. When heated to 239 , they give out 
six of their seven equivalents of water, and are converted into a 
grayish-white mass known as the dried sulphate. The alkalies 
and alkaline earths and their carbonates, silver nitrate, and lead 
acetate, are incompatible with this salt. Ferrous sulphate is one 
of the most active of the ferruginous preparations, but its local 
effects are powerfully astringent, and in a concentrated form it 



102 MATERIA MEDICA — NEUROTICS. 

acts as an irritant poison. It is preferred to other chalybeates 
where there is much relaxation of the solids, with excessive dis- 
charges ; but it is not so well adapted to long-continued use, on 
account of its local irritant action. Topically, it is employed in 
substance and solution as a styptic and astringent. Dose, gr. 
j-v, in pill ; of the dried sulphate (Jerri sulphas exsiccatus), gr. ss 
— iij . Ferrous sulphate is also used as a disinfectant, dissolved 
in water, to cleanse privies, drains, etc. 

Ferri Sulphas Prcecipitatus (Precipitated Ferrous Sulphate). In 
this preparation the ferrous sulphate is precipitated from a 
solution of sulphuric acid and water by alcohol. Dose, gr. j— v. 

Liquor Ferri Tersulphatis (Solution of Iron Tersulphate) 
(Fe 2 3S0 4 ). This preparation is made by dissolving ferrous sul- 
phate in a mixture of sulphuric and of nitric acids, with water. 
The nitric acid furnishes oxygen, which converts the iron from 
a ferrous to a ferric condition. It is a solution of the normal 
ferric sulphate. This solution is a clear, reddish-brown liquid, 
nearly devoid of odor, and of a sour, very styptic, and somewhat 
acrid taste. Its chief use is in making ferric hydrate, and it 
should be kept on hand for the preparation of the antidote 
for arsenious acid. It may be used as a styptic, but for this 
purpose it is inferior to the next preparation. 

Liquor Ferri Subsulphatis (Solution of Iron Subsulphate) 
(MonseVs Solution) is made in the same way as the last prepa- 
ration, except that only half the amount of sulphuric acid is 
used, and a basic ferric sulphate results (Fe 4 05S0 4 ). It has a 
syrupy consistence, a ruby-red color, is inodorous, and has a 
very astringent but not acrid taste. This is a solution of the 
basic ferric sulphate, and is less irritant than that of the normal 
ferric sulphate. It may be used internally, in hemorrhage from 
the stomach and bowels, in the dose of from ^v-xv. Exter- 
nally, it is one of the most efficacious styptics we can employ ; 
and has been injected into varicose veins with success for the 
cure of varicose ulcers, and applied by means of the atomizer, 
has been found efficient in hemoptysis. Diluted with water, it 
is a good local application to inflamed mucous surfaces. Cotton 
saturated with Monsel's solution (styptic cotton) and dried, may 
be pressed firmly into a wound to arrest capillary oozing. 

Ferri Chloridum (Ferric Chloride) (Fe 2 Cl 6 .i2H 2 0) is made 



TONICS PREPARATIONS OF IRON. 1 63 

by heating iron wire with hydrochloric acid (by which ferrous 
chloride is formed), and afterward converting the ferrous into 
ferric chloride by heating it with hydrochloric and nitric acids. 
It occurs in fragments of a crystalline structure, an orange- 
yellow color, inodorous, of a strong chalybeate, styptic taste, 
deliquescent, and wholly soluble in water, alcohol and ether. 
Internally, it is used chiefly in the form of the tincture. Exter- 
nally, it is applied as a styptic, and in solution, of various 
strengths, as an astringent. One part, gradually added to six 
parts of collodion, forms a yellowish-red, limpid liquid, of valu- 
able styptic properties. 

Liquor Ferri Chloridi {Solution of Ferric Chloride) is prepared 
by dissolving iron wire in hydrochloric acid, heating to the 
boiling point, then heating the liquid, after filtration, with 
hydrochloric and • nitric acids, and afterward adding distilled 
water. A reddish-brown liquid, having an acid and strongly 
styptic taste, and sp. gr. 1.405. It may be used internally for 
the purposes of the chloride, in doses of ^ij-vj, diluted, and 
externally as a styptic. 

Tinctura Ferri Chloridi (Tincture of Ferric Cldoride) is made 
by mixing 35 parts of solution of ferric chloride with 65 parts of 
alcohol. It is a tincture of the chloride, though there is prob- 
ably some reaction between the acid and alcohol, as the prepa- 
ration has an ethereal odor. It is of a reddish-brown color, 
and has a sour, styptic taste. It is one of the most effective of 
the chalybeates, acting locally as an energetic astringent and 
styptic, and, in large doses, as an irritant. Its indications, both 
general and topical, are very analogous to those of the sulphate, 
and it is the preparation of iron usually employed internally. It is 
especially useful in erysipelas. Dose, ^x to xxx, which may 
even be gradually increased to f oj, in certain diseases (as 
erysipelas). It should be taken well diluted after eating, and 
through a glass tube to avoid injury to the teeth. Attention 
has been called by Prof. T. D. Reed* to the addition of 
potassium citrate in prescribing tincture of ferric chloride, 
which forms with it (probably ferric citro-chloride) a clear, 
light-green solution, possessing similar ferruginous properties, 

* Canada Med. and Surg. Jown., August, 1881, p. 7. 



164 MATERIA MEDICA NEUROTICS. 

free from the roughness of the iron, and compatible with the 
astringents and bitters. ^ Tincturi ferri chloridi, fSij ; potassii 
citratis, 5j ; syrupus limonis, fSjss ; aquae, ad f§vj. M. S. — One 
tablespoonful represents ^x of the iron — an elegant prepara- 
tion. 

Mistura Ferri et Ammonii Acetatis {Mixture of Iron and 
Ammonium Acetate) {Baskam's Mixture) is made with tincture 
of ferric chloride, diluted acetic acid, solution of ammonium 
acetate, elixir of orange, syrup and water. By the reaction of 
the ferric chloride and ammonium acetate, ferric acetate and 
ammonium chloride are formed. A most excellent preparation, 
and of great benefit in chronic albuminuria and in chronic drop- 
sies generally where iron is indicated. Dose, fSss-j. 

Ferri Iodidum Saccharatum {Saccharated Ferrous Iodide). 
This salt is made by the addition of iron filings to a mixture of 
iodine in distilled water, and sugar of milk is added to prevent 
oxidation. By evaporation a yellowish-white or grayish powder 
is obtained, of a sweetish, ferruginous taste, deliquescent, and 
very soluble in water. Dose, gr. x-xxx. 

Syrupus Ferri Iodidi {Syrup of Ferrous Iodide), which is pre- 
pared by mixing iodine and iron wire in distilled water, and 
shaking the mixture until the solution has acquired a green 
color, adding syrup, heating to 21 2°, straining, and, when the 
liquid has cooled, adding distilled water. It must be kept in 
well-stoppered vials. It is a transparent liquid, of a pale-green 
color, and furnishes an excellent alterative tonic, combining the 
effects of iodine and of iron, and is particularly applicable to the 
treatment of scrofula, rickets, and phthisis. It is incompatible 
with the alkalies, their carbonates, and tannin. Dose, ^v-f5j. 

Pilulce Ferri Iodidi {Pills of Ferrous Iodide) are made with 
iodine, reduced iron, sugar, acacia, glycyrrhiza, extract of gly- 
cyrrhiza, and an ethereal solution of balsam of tolu. They keep 
very well. Each pill contains about gr. j of ferrous iodide and 
gr. y^ of reduced iron. 

Ferri et Potassii Tartras {Iron and Potassium Tartrate) is 
prepared by the addition of ferric hydrate to a mixture of potas- 
sium bitartrate in distilled water. It occurs in transparent 
scales of a ruby-red color, which are wholly soluble in water. 
The tartaric acid and potash, in combination in this preparation, 






TONICS PREPARATIONS OF IRON. 1 65 

render it less constipating than the other chalybeates : and, from 
its agreeable taste, it is adapted to the diseases of childhood. It 
is, moreover, not incompatible with alkalies. Dose, gr. x— 5ss. 

Ferri Phosphas [Ferric Phosphate) is obtained by the double 
reaction of solutions of ferric citrate and sodium phosphate and 
evaporating to dryness. It occurs in bright-green transparent 
scales, insoluble in alcohol, but soluble in water ; by exposure 
to the light it becomes darker. According to Rother * it is a 
combination of ferric phosphate and sodic citrate. Dose, gr. 
v-x, in pill. 

Ferri Pyrophosphas {Ferric Pyrophosphate) (Fe 4 3P 2 7 .9H 2 0). 
It occurs in apple-green scales, of an acid, slightly saline taste, 
and is very soluble in water. A good chalybeate. Dose, gr. ij 
— v. Given also as a syrup. 

Ferri Hypophosphis {Ferric Hypo phosphite) (Fe 2 6H 2 P0 2 ) is 
obtained by the reaction of a solution of sodium or ammonium 
hypophosphite with a solution of ferric sulphate. It is a white, 
amorphous powder, insoluble in cold water, soluble in hydro- 
chloric acid, incompatible with the soluble salts of mercury and 
silver, but has the advantage of not being decomposed by the 
cincho-tannic acid of cinchona. This is a good chalybeate in 
diseases of degeneration of the nervous tissue, and has been also 
given in phthisis ; other hypophosphites are combined with it. 
Dose, gr. x-xxx, t. d. 

Ferri Citras [Ferric Citrate) (Fe 2 2C 6 H 5 7 .6H 2 0) is prepared 
by the addition of ferric hydrate to a solution of citric acid, and 
occurs in thin, transparent pieces, of a garnet-red color, with a 
mild, acid, chalybeate taste, slowly soluble in cold water, but 
readily soluble in boiling water. Dose, gr. v-x. It is officinal 
also in the form of Liquor Ferri Citratis [Solution of Ferric Citrate), 
a deep reddish-brown liquid, given in doses of gtt. x-xx ; and it 
is by evaporating this solution that the solid citrate is obtained. 

Liquor Ferri Nitratis [Solution of Ferric Nitrate) (Fe 2 6N0 3 ) 
is prepared by the gradual addition of diluted nitric acid to ferric 
hydrate. It is a pale, amber-colored liquid, with a strong, 
astringent acid taste. It is tonic and astringent, agreeing very 
well with the stomach, and is employed in the treatment of 

* Am. Jour. Pharm., 1876, p. 171, and 1883, p. 163. 



I DO MATERIA MEDICA NEUROTICS. 

chronic diarrhoea, hematemesis, hemorrhage from the bowels, 
and uterine hemorrhage, particularly when anaemic symptoms 
are present. Dose, gtt. x-xx, t. d., in dilution. 

Syrupus Ferri Bromidi (Syrup of Ferrous Bromide) contains 
10 per cent, of ferrous bromide. It may be given with advantage 
where a bromide and iron are both indicated, notably in chorea 
occurring in delicate girls at the age of puberty, and associated 
with anaemia. Dose, foj. 

Ferri Oxalas {Ferrous Oxalate) (FeC 2 4 .H 2 0) is made by the 
reaction of solutions of oxalic acid and ferrous sulphate. It 
occurs as a lemon-yellow, crystalline powder, almost destitute 
of taste, slightly soluble in water, but easily acted upon by the 
diluted acids, and decomposed by the alkalies and their carbon- 
ates. This chalybeate has the advantage of being well borne by 
the stomach, and of being readily absorbed, while it is nearly 
destitute of astringency, and not disposed to change like the 
ferrous salts generally. Dose, gr. ij-iij, in pill, t. d. 

Liquor Ferri Acetatis {Solution of Ferric Acetate). Dose, 
f^x-xxx. Chiefly used in preparing 

Tinctura Ferri Acetatis (Tincture of Ferric Acetate), a solu- 
tion of ferric acetate in alcohol and acetic ether. Dose, ^x- 
f5ss, or more. 

Ferri Lactas {Ferrous Lactate) is made by mixing diluted 
lactic acid with iron filings. It occurs in greenish-white crys- 
talline crusts or grains of a mild, sweetish, ferruginous taste, 
sparingly soluble in water, and insoluble in alcohol. Used in 
chlorosis, it has a marked effect in increasing the appetite. 
Dose, gr. x-xx, in pill, lozenge or syrup. 

Ferri et Quinine Citras (Iron and Quinine Citrate). This 
salt is prepared by dissolving quinine in a hot solution of iron 
citrate and evaporating the solution. As found in the shops, it 
is a mechanical mixture of ferric citrate with a variable propor- 
tion of iron and quinine citrate. It occurs in thin, transparent 
scales, of a reddish or yellowish-brown color, with a tint of 
green, not very soluble in water, and of a ferruginous, moder- 
ately bitter taste. It combines the virtues of its two bases, and 
is thought to have an especial agency in diminishing the forma- 
tion of urea by the kidneys, whence its use in uraemia. Dose, 
gr. v-x. 



TONICS PREPARATIONS OF IRON. 1 67 

Liquor Ferri et Quinine Citratis (Solution of Iron and 
Quinine Citrate). Dose, foj. 

Vinum Ferri Amarum [Bitter Wine of Iron) is a mixture of 
solution of iron and quinine . citrate, tincture of sweet orange 
peel, syrup and stronger white wine. Dose, f5j-ij. 

Ferri et Ammonii Citras (Iron and Ammonium Citrate) is 
made by adding water of ammonia to solution of iron citrate, 
and evaporating. It occurs in the form of garnet-red translu- 
cent scales, of a slightly ferruginous taste, and is readily soluble 
in water ; it has antacid properties. Dose, gr. v-x. 

Vinum Ferri Citratis ( Wine of Citrate of Iron), a solution of 
ammonio-ferric citrate in tincture of sweet orange peel, syrup 
and stronger white wine. Dose, f5j. 

Ferri et Strychnine Citras (Iron and Strychnine Citrate) 
is made by mixing a solution of strychnine and citric acid in 
distilled water with a solution of iron and ammonium citrate 
in water, and evaporating. It occurs in garnet- red scales, of 
a bitter, ferruginous taste, readily soluble in water. An excel- 
lent tonic. Dose, gr. ij-iij, t. d. 

Syrupus Ferri, Quinine et Strychnine Phosphatum (Syrup 
of Iron, Quinine and Strychnine Phosphates), an agreeable tonic. 
Dose, f5j. 

Ferri et Ammonii Sulphas (Iron and Ammonium Sidp hate, 
(NH 4 )2Fe2(S04)4.24H 2 0). This salt, called also ammonio-ferric 
alum, is made by adding ammonium sulphate to a hot solution 
of ferric sulphate. It occurs in octahedral crystals, of a pale- 
violet color and sour, astringent taste, efflorescent, and very 
soluble in water. Used in diarrhoea and chronic dysentery. 
Dose, gr. v-xv, two or three times a day. 

Ferri et Ammonii Tartras (Iron and Ammonium Tartrate) 
(2(FeQ)NH 4 C4H 4 6 .5H20) occurs in transparent, garnet-red 
scales, of a sweetish taste, soluble in water, insoluble in alcohol 
and ether. A mild chalybeate. Dose, gr. x-xxx. 

Ferri Valerianas (Fei'ric Valerianate), a dark, tile-red, amor- 
phous powder, with a mildly styptic taste and an odor of 
valerianic acid ; insoluble in cold water, but readily soluble in 
alcohol. Dose, gr. j-iij. 

Ferrum Dialysatum (Dialyzed Iron) has been introduced as 
a substitute for the tincture of ferric chloride, than which it is 



1 68 MATERIA MEDICA NEUROTICS, 

much less efficacious. It is not apt to constipate, is almost 
tasteless, and may be given in doses of from gtt. xv-1 daily. 
Dialyzed iron is an antidote to arsenic in the stomach. To 
ensure its conversion into ferric hydrate in the stomach, its 
ingestion should be followed by a tablespoonful of sodium 
chloride. It is not officinal. 

Pills of aloes and iron and syrup of the hypophospJdtes with 
iron are also officinal. 

MANGANI PR.EPARATA PREPARATIONS OF MANGANESE. 

Manganese (Mn) is a normal constituent of the body, existing 
in small amounts in the blood, hair, bile, etc. When given inter- 
nally in small doses the appetite improves, the digestive functions 
are promoted and the body gains in weight ; these effects are 
supposed to be most conspicuous in conditions due to an insuf- 
ficiency of iron, and probably of manganese, in the blood. If 
a large dose be taken the cardiac action is depressed and the 
blood pressure lowered. After a toxic dose violent gastro- 
enteritis ensues. Injected into the blood, or given hypodermic- 
ally, the salts of manganese paralyze voluntary motion and 
reflex action and arrest the heart in diastole. They have been 
used as substitutes for, or combined with, the iron salts, in 
anaemia, chlorosis, and cachectic states, but are inferior to the 
latter remedies. 

The following are the officinal preparations : — 

Mangani Oxidum Nigrum {Manganese Black Oxide) is the 
" native, crude Manganese Binoxide, containing at least 66 per 
cent, of the pure oxide (Mn0 2 )." It is a heavy, grayish-black, 
amorphous or crystalline powder, odorless, tasteless and insolu- 
ble in water or alcohol. It has been used as a substitute for 
iron in the above-mentioned diseases and as a substitute for 
bismuth in gastrodynia and pyrosis. Dose, gr. j— x in pill, cap- 
sule or powder. 

Mangani Sulphas {Manganese Sulphate) (MnS0 4 4H 2 0) occurs 
in transparent and colorless or pale rose-colored crystals, slightly 
efflorescent in dry air ; without odor, but having a faintly bitter, 
astringent taste ; soluble in water but not in alcohol. Its effects 
are those as above stated, and it is much more active than the 
black oxide. It is believed, also, to act as a cholagogue, and 



TONICS MINERAL ACIDS. 1 69 

it has been used for this purpose in jaundice, especially when 
due to catarrh of the biliary ducts or when of malarial origin. 
It has also been used as a substitute for iron. Dose, gr. ij-v. 

Potassium Permanganate is considered among the antiseptics, 
q. v. 

ACIDA MINERALIA MINERAL ACIDS. 

The diluted mineral acids are usually classed with tonics ; but, 
although they exert a very considerable corroborant influence 
on the system, their action is in many respects peculiar and dis- 
tinctive. In the concentrated form they are corrosive. When 
properly diluted with water and swallowed in medicinal doses, 
they allay thirst, increase the appetite, stimulate digestion, 
increase the flow of bile by duodenal irritation, and all possess 
great diffusive power. After absorption into the blood, they 
combine either with its alkaline bases or albumen, and often 
produce a restorative effect in morbid conditions of the circu- 
lating fluid, and in their passage out by the secretions act as 
astringents. Acids given on an empty stomach check the secretion 
of the acid gastric juice ; given on a. full stomach they render its 
contents more acid; hence, if there is an excess of acid secreted 
by the stomach, they should be exhibited before meals, in small 
doses and well diluted ; while if there is too little acid secreted, 
they may be given after meals to supply the deficiency. They 
are employed — as tonics, usually in combination with the vege- 
table bitters, in dyspepsia, especially where it is dependent on a 
deficiency of gastric fluid, in typhoid and other essential fevers, 
in purpura and in scurvy ; as astringents and styptics, in hem- 
orrhage from the stomach and bowels and in colliquative sweats 
and diarrhoea ; to allay febrile heat and cutaneous irritation ; in 
phosphatic lithiasis ; and locally, as escharotics ; and in very 
dilute solutions they are injected into the bladder as lithontrip- 
tics. In cases of poisoning from the mineral acids the proper 
antidotes are the alkalies or the alkaline earths to neutralize the 
acid and thus render it inert, and the free use of the fixed oils 
or albumen to protect the surface of the alimentary tract. 

Acidum Sulphuricum (Sulphuric Acid) (H 2 S0 4 ), formerly 
called Oil of Vitriol, is obtained by burning sulphur, mixed with 
nitre, over a stratum of water contained in a chamber lined 
with sheet-lead. It is a dense, colorless, inodorous, corrosive 



I70 MATERIA MEDICA NEUROTICS. 

liquid, of a strongly acid taste and an oily consistence, which 
unites with water in all proportions with the evolution of heat. 
Its sp. gr. should not be lower than 1.840. It should contain 
not less than 96 per cent, of absolute sulphuric acid, and not 
more than 4 per cent, of water. The diluted acid is readily 
detected by a soluble barium salt, which precipitates a white 
insoluble barium sulphate ; veratrine introduced into the diluted 
acid, and evaporated to dryness, leaves a crimson deposit. In 
the concentrated form it is not employed internally, but is some- 
times used externally as a caustic, acting by coagulating albu- 
men, and its affinity for water and organic bases. Diluted sul- 
phuric acid lessens thirst, aids digestion, and diminishes the 
secretions of the bowels and skin. According to Gubler, the 
mineral acids exist in the blood loosely combined with albumen, 
and by the action of the excretory organs this combination is 
broken up, the albumen remaining in the vessels and the acid 
passing out united with other bases. When swallowed, it acts 
as a violent corrosive poison, causing a burning pain in the 
mouth, throat and stomach, and usually staining the lips, mouth 
and fauces with black sloughs ; occasionally the action of the 
poison is spent upon the upper part of the larynx, and death 
takes place from asphyxia, without the entrance of the poison 
into the stomach. The chemical antidotes are magnesia, chalk, 
the alkalies or solution of soap, and mucilaginous drinks should 
be afterward freely administered. 

Acidum Sulphuricum Dilutum (Diluted Sulphuric Acid) con- 
tains one part of sulphuric acid and 9 parts of distilled water. 
It therefore contains 10 per cent, of the officinal (not the abso- 
lute) sulphuric acid. It is given as a tonic, refrigerant and 
astringent, in the dose of from gtt. x-xxx, t. d., in water, and 
should be sucked through a tube to prevent injury to the teeth. 
This acid is a particularly valuable remedy in typhus and typhoid 
fevers, colliquative perspirations, cholera and choleraic diar- 
rhoea ; and it is the best corrective for phosphatic lithiasis. It 
is used externally as a gargle and a wash to ulcers. 

Acidum Sulphuricum Aromaticum (Aromatic Sulphuric Acid*), 
or Elixir of Vitriol, is made by adding 200 parts of sulphuric 
acid to 700 parts of alcohol and allowing the mixture to cool, 
then add 45 parts tincture of ginger and 1 part of oil of cinnamon, 



TONICS MINERAL ACIDS. I/I 

with sufficient alcohol to make the product weigh ioocf parts. 
It is a reddish-brown liquid, with an aromatic odor and a pleasant 
acid taste ; and is an agreeable substitute for the diluted sulphuric 
acid, administered in the same doses. 

Acidum Nitricum {Nitric Acid) (HN0 3 ) is obtained by the 
action of sulphuric acid upon potassium nitrate. When pure 
it is colorless ; but as found in the shops it is usually of a 
straw-color, owing to the presence of nitric peroxide. It should 
have a sp. gr. 1.420 and contain 69.4 per cent, of anhydrous 
acid. It is a corrosive, sour liquid, evolving white fumes when 
exposed to the air. It may be recognized by giving off dense 
red fumes when added to copper turnings, by the morphine 
test (see p. 75), and by striking a blood-red color, changing to 
yellow in minute quantity, with solution of sulphuric acid and 
brucine. Nitric acid is readily absorbed by the blood, and 
probably exists there either in the form of nitrates or com- 
bined with albumen (Gubler). Nitric acid stimulates the 
glandular apparatus of the intestinal canal, apparently due to a 
local action. It is probably eliminated as a nitrate by the 
kidneys. Locally, nitric acid is a powerful caustic, acting by 
abstracting water and combining with the alkaline bases of the 
tissues. It is employed, in the concentrated form, as an escha- 
rotic to destroy warts and stimulate indolent sinuses, and diluted, 
as an astringent wash or gargle. Atthill * applies the fuming 
nitric acid within the uterus successfully, in the treatment of 
granulations of the mucous membrane, in hemorrhage after the 
removal of a polyp, cervicitis and endocervicitis, on cotton 
wrapped round copper wire or a catheter, the cervix being pro- 
tected by a vulcanite tube. He states that applied in this way it 
seldom causes pain. Cases of poisoning from this acid are to be 
treated with magnesia, the alkalies, or soap, and mucilaginous 
drinks. In poisoning from nitric acid, the fauces and mouth are 
covered with yellow eschars, due to the formation of picric acid. 
Internally, it is used in the form of — 

Acidum Nitricum Dilutum (Diluted Nitric Acid), which con- 
tains one part of nitric acid and six parts of water, by weight ; 
or 10 per cent, of absolute acid. This is given as a substitute 

* " Clinical Lectures on Diseases Peculiar to Women," 1883, pp. 104, 199, 378. 



1/2 MATERIA MEDICA NEUROTICS. 

for sulphuric acid. Dose for internal use ^ij-xx, t. d., reduced 
with water. 

Acidum Hydrochloricum [Hydrochloric Acid — Muriatic Acid} 
is an aqueous solution of hydrochloric acid gas (HC1), of sp. gr. 
1. 1 60, and is obtained by the action of sulphuric acid on a solu- 
tion of sodium chloride. The officinal acid is composed of 31.9 
per cent, of absolute hydrochloric acid, and 68.1 per cent, of 
water. It is, when pure, a transparent, colorless liquid, but has 
often a yellow color, owing to the presence of chlorine, iron, or 
other contamination. It gives off dense white fumes when in 
contact with ammonia, and evolves chlorine gas when heated 
with manganese dioxide ; in the diluted stage it produces, with 
solution of silver nitrate, a white precipitate, insoluble in boiling 
nitric acid, but soluble in ammonia. Locally, it is an active 
caustic, abstracting water and uniting with the alkaline bases of 
the tissues. Strong baths of hydrochloric and other mineral 
acids exert a powerful influence upon the skin. Hydrochloric 
acid is readily absorbed by the stomach, either as a chloride or 
joined with albumen. Hydrochloric acid, in small quantities, 
augments the digestive power of the gastric juice, and, probably, 
exists normally in that fluid. Hydrochloric acid is chiefly 
eliminated by the urine. It has a corrosive taste and a suffo- 
cating odor, and is an active poison, though less irritating than 
sulphuric and nitric acids. A poisonous dose produces black- 
ness of the lips, redness of the tongue, difficulty in swallowing, 
and violent gastric pain. Magnesia, soap, or the alkalies are the 
chemical antidotes. Afterward mucilaginous drinks should be 
given. It is used externally as a caustic, and as an application 
in diphtheria, ulcerative and gangrenous stomatitis, and, inter- 
nally, in the form of 

Acidum Hydrochloricum Dilutum {Diluted Hydrochloric 
Acid — Diluted Muriatic Acid), which contains 6 parts of the 
officinal acid and 13 parts of water, by weight; or 10 per cent, 
of the absolute acid. This is employed in typhoid and typhus 
fevers ; also to counteract phosphatic deposits in the urine, and 
in dysentery. In gastric dyspepsia attended with deficiency of 
the gastric juice, since it exists probably normally* in this fluid, 

* " Human Physiology," 1887, p. 139. Chapman. 



TONICS MINERAL ACIDS. 1 73 

it is useful, especially when combined with pepsin ; the liquor 
pepsini, as it contains both remedies, is an eligible preparation 
in this condition and should be taken after meals. Dose, *Kv— 
xx, which may be given in infusion of rose. 

Acidum Nitro-Hydrochloricum {Nitro-Hydrochloric Acid — 
Nitro- Muriatic Acid). This acid is made by mixing 4 parts of 
nitric acid with 15 parts of hydrochloric acid, the resulting 
reaction liberating chlorine, and forming chloronitrous acid and 
water, as follows : HN0 3 + 3HCI = Cl 2 + NOC1 (chloronitrous 
acid) -f- 2H 2 0. It has a deep golden-yellow color, and emits 
the smell of chlorine, which is the chief active constituent. 
Internally, it is employed as a stomachic tonic, and is thought 
also to be particularly efficacious in oxaluria and diseases of 
the liver. Rutherford's experiments on dogs show that it is 
an hepatic stimulant. It should not be given with mercurials. 
Externally \ it is used as a bath, either local or general, in 
oxaluria and chronic hepatitis, for which purpose one or two 
ounces of acid may be added to a gallon of water. Dose, from 
gtt. ij-v, properly diluted, and carefully increased. 

Acidum Nitro-Hydrochloricum Dilutum {Diluted Nitro- 
Hydrochloric Acid — Diluted Nitro- Muriatic Acid) is made by 
mixing nitric acid (4 parts) with hydrochloric acid (15 parts), 
and, when effervescence ceases, adding distilled water (j6 parts). 
Dose, ^ij-x. 

Acidum Phosphoricum [Phosphoric Acid) is made by boiling 
phosphorus in nitric acid and water, and driving off the nitrous 
compounds by heat. It contains 50 per cent, each of ortho- 
phosphoric acid (H3PO4) and distilled water, and is " a colorless 
liquid, without odor, of a strongly acid taste and reaction," and 
has a sp. gr. of 1.347. It is a powerful caustic, penetrating the 
tissues very deeply. In its effects it resembles the other acids. 
In small doses, well diluted, it stimulates digestion and increases 
the circulation ; when given for too long a time it disorders 
digestion by diminishing the secretion of acid gastric juice. In 
large doses it depresses the circulation, acting as a corrosive 
poison. Cases of poisoning by phosphoric acid are to be treated 
on general principles, viz. : neutralize the acid by alkalies, alka- 
line earths or soap ; protect the denuded surface by eggs, milk 
or mucilaginous drinks ; and counteract the resulting depression 



174 MATERIA MEDICA NEUROTICS. 

by opium, nutrient and stimulating injections, etc. It is used 
internally in the form of 

Acidum Phosphoricum Dilutum (Diluted Phosphoric Acid) 
which is prepared by adding 20 parts of phosphoric acid to 80 
parts of distilled water. It is a colorless, syrupy liquid, without 
smell, but having a sour taste, and contains 10 per cent, of 
orthophosphoric acid. 

It has been used as a tonic and alterative in scrofulous affec- 
tions and in rachitis, but in the latter disease the phosphates are 
justly preferred. It may be used in dyspepsia, especially in 
those forms attended with acid eructations, heartburn, and 
ulcerative stomatitis, and due to fermentation of food or 
excessive secretion of acid by the stomach. In these cases it 
should be given before meals. It is often added to cough mix- 
tures. As it contains no free phosphorus it should not be given 
to produce the medicinal effects of that drug (Farquharson). 
Dose, ^x-xxx diluted. 

ACIDUM LACTICUM LACTIC ACID. 

This acid (HC s H 5 3 ) is formed in the souring of milk by the 
fermentation of its sugar under the influence of casein, between 
68° and 84 F., and is a " syrupy, colorless, or pale wine-yellow 
liquid, having a slight bland or no odor, a very sour taste, and a 
sp. gr. 1.2 1 2." The officinal acid contains 75 per cent, of absolute 
lactic acid. Lactic acid unites in all proportions with water, alcohol, 
and ether, but is insoluble in chloroform and carbon bisulphide. 
In its effects it resembles the mineral acids, aiding digestion in 
small doses, while in large doses it disorders the stomach, causing 
flatulence and epigastric pain. It is a normal ingredient of the 
gastric juice, and it seems probable that the acidity of this secre- 
tion depends partly upon its presence. At all events, as far as 
digestion is concerned, it answers equally well with HO. 

Given in large doses and long continued, it has caused rheu- 
matic pains. 

It has been used in certain forms of dyspepsia depending on 
a deficiency of acid in the gastric juice, as in atonic dyspepsia, 
apepsia, and irritative dyspepsia, when it is given after meals and 
frequently combined with pepsin ; in acidity and heartburn it 
may be given before meals to decrease the secretion of acid. 



I" 



TONICS PHOSPHORUS. I 75 

It has also been used for the removal of phosphatic deposits in 
the urine when these depend on disordered digestion. As a 
solvent for the false membranes of croup or diphtheria it has been 
used as a gargle or by atomization. Dose, ^x-xxx, well 
diluted. 

PHOSPHORUS. 

Phosphorus (P), which is never found in a free state in nature, 
is obtained from the calcium phosphate of bone-ash, by removing 
the lime with sulphuric acid, and afterward deoxidizing the 
residuum by heating with charcoal. It is a translucent, highly 
inflammable, nearly colorless solid, resembling wax, without 
taste, but having a peculiar garlicky smell; sp. gr. 1.830. It is 
insoluble in water, and dissolves sparingly even in the oils, ether, 
and alcohol, but is soluble in carbon bisulphide. It emits, when 
exposed to the air, white fumes, which are luminous in the dark. 
It should be kept under water to prevent combustion. 

Physiological Effects. — Locally: when applied to the skin, 
phosphorus produces inflammation, ulceration, and even gan- 
grene. The fumes of phosphorus are irritating to the con- 
junctival and respiratory mucous membranes, and may produce 
necrosis of the maxillae, if the person exposed has t caries of the 
teeth. This form is mostly observed among the artisans of 
match factories. Nervous system : in small doses, it is a tonic 
and stimulant to the nervous system, aiding in the repair of 
waste. Circulation : phosphorus is absorbed by the blood, 
according to Bamberger. Either in the stomach or after enter- 
ing the blood, a portion must unite with oxygen or hydrogen, 
as the odor of a phosphuretted compound is generally percep- 
tible in the exhaled air of a person taking it. It stimulates the 
circulation, increasing the frequency and fullness of the pulse, 
and producing dilatation of the cutaneous capillaries. Large 
doses depress and weaken the cardiac action. Temperature : 
this is slightly elevated. Secretion : it increases the urinary 
secretion and the relative proportion of urea excreted, and gives 
to the urine an odor of violets. It stimulates the skin and in- 
creases the perspiration. In poisoning from phosphorus, albu- 
minuria and hematuria have been observed. Osseous system : 
it stimulates the formation of bone, 'especially of the compact 
tissue, and the proportion of inorganic to organic matter is 



I76 MATERIA MEDICA NEUROTICS. 

increased (Wegner *). Elimination : phosphorus passes out of 
the system by the liver and other glands, by the pulmonary 
mucous membrane, and by the skin. 

Poisoning : when taken in large doses, or for a considerable 
time, phosphorus acts as a gastro-intestinal irritant, causing 
vomiting, purging, abdominal pain, an alliaceous taste in the 
mouth, the vomited matters and sometimes the stools being* 
phosphorescent. Toward the end the pupils dilate, the abdo- 
minal walls are sensitive to pressure, there is great thirst and 
anxiety, and death may be preceded by convulsions. Hart- 
man,")" asserts that the temperature is finally elevated, the faeces 
of normal color, while the urine contains biliary pigment and 
acids. Jaundice is a frequent sequela; according to Alter,J the 
pathological changes involved in its production are swelling of 
the mucous membrane of the biliary passages and hypersecre- 
tion of bile — both due to fatty infiltration of the biliary epithe- 
lium and followed by absorption of bile. Wolfs, § who has 
studied the post-mortem appearances in sixteen cases, states 
that the blood is rendered more fluid, coagulation prevented, 
and the corpuscles altered in form. Vetter,|| however, found the 
latter in normal condition. Hemorrhages take place or form in 
the serous cavities, especially in the pericardium and pleura, due, 
doubtless, to the changes in the blood and fatty degeneration 
of the capillaries and arterioles. The liver becomes atrophied 
(not always), undergoes fatty degeneration of its cells, as do 
also the other tissues, notably the muscles. The heart is soft 
and pale, and the parenchyma and cortex of the kidneys infil- 
trated with fat cells. In fact, the ingestion of phosphorus, 
either in toxic amount or continuously, tends to the production 
of a general steatosis. Death has been caused by gr. jss-iij, also 
from swallowing an infusion of matches (Woodman and Tidy T). 
The period when fatal varies from a few hours to seven days. 
Antidotes: in cases of poisoning, an emetic should be adminis- 
tered at once, preferably copper sulphate repeatedly in small 
doses, partly for its emetic action and partly as a chemical anti- 

* Virchow' s Archives, 55, p. II. 

I " Zur acuten Phosphorvergiftung," Dorpat, 1866. 

% " Inaug. Diss.," Breslau, 1867. \ " Inaug. Diss.," Berlin, 1868. 

|| Virchoiv's Archives, 53, p. 168. \ " Forensic Med.," etc., 1882, p. 95. 



TONICS PHOSPHORUS. 1 77 

dote, since Bamberger * has shown that it forms with this salt a 
phosphide, thus checking the intensity of its effects. The oil of 
turpentine, an antidote introduced by Andant,t who exemplified 
its virtues in the case of a woman poisoned by matches, has 
been frequently and with success employed against phosphorus 
(LaboulleneJ Lecorche,§ Rommelaere ||). Personnel experi- 
menting on dogs poisoned with phosphorus, observed that almost 
all recovered to whom turpentine had been given. He thought 
it formed with phosphorus an insoluble mass or inert combina- 
tion (turpento-phosphoric acid, a spermaceti-like substance). 
French acid oil of turpentine, according to Vetter, (loc. cit.) must be 
administered, and it should be old, as the real antidote appears 
to be oxygen in the form of ozone contained in oxygenated oil 
of turpentine. Fats and oils are to be avoided, as they increase 
the solubility of phosphorus. The after-treatment consists in 
the exhibition of a brisk cathartic, such as magnesia. 

The most delicate test for free phosphorus is that of Mitscher- 
lich, which consists in distilling the suspected substance with 
weak sulphuric acid in a flask and conducting the vapor in a 
tube through a glass condenser, the tube terminating in a bottle 
containing water placed under the condenser. That portion of 
the tube passing through the condenser must be surrounded by 
cold water contained within the latter, which, if phosphorus be 
present in the distillate, will condense it, causing a peculiar 
luminosity to be visible when observed in the dark. The water 
in the bottle may also be tested for phosphorus. 

Uses. — In medicinal doses, phosphorus is a valuable stimulant 
and tonic to those tissues in which it is normally found, and has 
been employed with advantage in cases of nervous exhaustion 
and degeneration of nerve tissue, and especially in neuralgia; 
though Anstie ** says its utility is not extensive nor reliable in 
the last disease. It is administered with benefit in osteomalacia 
and rickets, and has proved useful in some cases of pernicious 
anaemia. It is one of the best remedies we possess in func- 

* Wilrzburger Medicinische Zeit., 1 866, p. 41. 
f Bull. Gen. de Therap , 75, p. 269; 76, p 273. 
% Gaz. des Hop., xlvi, p. 361 ; Gaz. Heb., 1874, p. 524. 

\ Arch, de Phys., t. i, p. 571 ; t. ii, p. 488. || Bull.Gen. de Thh-ap., 82, p. 145. 
^ Bull. Gen. de Therap., 76, p. 353. ** " Neuralgia," etc., 1871, p. 180. 

12 



I78 MATERIA MEDICA NEUROTICS. 

tional impotence, and has been given in certain cutaneous affec- 
tions, as lupus and psoriasis. The dose of phosphorus is gr. 
3^ ^2- The officinal preparations are: pilulce phosphori (phos- 
phorus pills); each pill contains gr. yto> °l eum phosphoratum 
(phosphorated oil), a solution of phosphorus (1 part) in ether (9 
parts) and almond oil (90 parts) ; dose, gtt. v-xx. 

Zinci Phosphidum (Zinc Phosphide), (Zn 3 P 2 ), prepared by sub- 
jecting fragments of zinc and phosphorus together to ebullition 
in a retort, through which a current of dry carbonic acid gas 
has been previously passed, has been employed in cases where 
the administration of phosphorus is indicated. It occurs as a 
gray, crystallized body, unaltered by moist air, and easily 
decomposed in the stomach, with the evolution of phosphur- 
etted hydrogen. It has been found efficacious in eczema, psoria- 
sis, and other cutaneous affections. Dose, about gr. -^-\. 



ORDER V. ASTRINGENTS. 

These are medicines which produce contraction and corruga- 
tion of the tissues by a local action. Their constitutional effects 
are somewhat analogous to those of tonics ; and, like them, they 
increase the tone and vigor of the body, and exercise a control 
over various disorders of the nervous system. But they are 
chiefly employed to cure relaxation of the fibres and tissues, to 
subdue inflammation of superficial parts, and to arrest hemor- 
rhage and excessive discharges from mucous membranes or 
other secreting surfaces. In checking morbid discharges from 
the bowels, astringents diminish the secretions from the intes- 
tinal canal, and restrain their peristaltic movements, accomplish- 
ing this by a local action. They are divided into Vegetable and 
Mineral astringents. Most of the former owe their astringency 
to the presence of a principle termed tannic acid, and differ 
from tonics in the absence of bitterness. The mineral prepara- 
tions usually classed among astringents are those of lead, cop- 
per, zinc, silver, bismuth and alum, and are distinguished from 
the mineral tonics by their more decided astringency and a 
sedative action on the vascular system. 



ASTRINGENTS TANNIC ACID. 1 79 

VEGETABLE ASTRINGENTS. 
ACIDUM TANNICUM TANNIC ACID. 

This acid, which is the active principle of the vegetable as- 
tringents, is usually extracted from powdered nutgall by the 
action of washed ether. The nutgall, made into a soft paste 
with ether, is enveloped in a canvas cloth, and is pressed be- 
tween tin plates ; the resulting cake is again mixed with washed 
ether and expressed ; and the expressed liquids are mixed, 
evaporated and dried ; the water seems to be the solvent which 
extracts the tannic acid. It is a light, feathery, non-crystalline 
powder, of a yellowish-white color and a strongly astringent 
taste, is very soluble in water, and soluble, though less so, in 
alcohol and ether. It produces a white flocculent precipitate 
with solution of gelatin, a bluish-black precipitate with ferric 
salts (ink), and white precipitates with solutions of the vegetable 
alkaloids ; and these substances are to be, therefore, considered 
incompatible with all the vegetable astringents. There is a variety 
of tannic acid (mimo-tannic acid) obtained from kino, catechu, 
and some other substances, which strikes a greenish- black pre- 
cipitate with the salts of iron, and is not convertible into gallic 
acid. Tannic acid (Ci 4 H 10 O 9 ) is a glucoside, yielding, besides 
glucose, gallic acid. Its hydrogen atoms are theoretically 
replaceable by bases, but the salts are not well defined. The 
most recent investigators consider tannic to be the anhydride of 
digallic acid. 

Effects and Uses. — Tannic acid applied locally to mucous mem- 
branes is a powerful astringent, and is applicable to all the cases 
in which astringents are useful. It precipitates peptones from 
watery solutions, but this does not take place in the presence 
of hydrochloric acid (Lewin). It checks the secretions of the 
mouth and stomach by constringing the caliber of the vessels, and 
it restrains intestinal peristalsis. Injected into the veins in large 
amount it coagulates albumen, causing fatal thrombosis. Intro- 
duced in the same way, more slowly, in moderate quantities, it 
exists as tannate of albumen, being held in solution by the 
alkaline carbonates (Lewin). According to Stockman's * inves- 
tigations tannic acid in the stomach unites with alkalies,- and in 

* Brit. Med. Jonrn., Dec. 4th, 1886, p. 1077. 



l80 MATERIA MEDICA NEUROTICS. 

the intestine is converted into gallic acid ; but it cannot be ob- 
tained as such, or at best a mere trace, from the blood. Tannic 
acid locally in dilute solution dilates the blood vessels, while 
strong contracts them, sometimes after brief dilatation. If its 
chemical affinities be satisfied it has no action on the vessels. 
Probably the alkaline tannates in the stomach are absorbed at 
once, and on the amount of this absorption depends the quantity 
in the urine ; for that in the intestine remains there a long while, 
being scarcely absorbed at all, is converted into gallic acid, and 
goes off by the bowel. Tannin is excreted in the urine of the 
rabbit as alkali tannate, while in man it may be given a long time 
before it can be detected there with ferric chloride. The remote 
effects of tannin as an astringent would seem to be valueless ; 
for when its affinities are satisfied in the blood, either with an 
alkali or albumen, it does not affect the calibre of the vessels or 
precipitate albumen. It is used ijttemally in the treatment of 
hemorrhage and colliquative sweats, while in diarrhoea and dys- 
entery it may act by forming a protective coating along the 
intestinal walls, and is frequently prescribed in the form of tinc- 
ture of catechu or kino. It is also used as an enema in diar- 
rhoea, dysentery, prolapsus ani and fissure of the rectum ; 
and, as a topical application, in hemorrhages, discharges from 
mucous membranes, as gonorrhoea (gr. ij-v to aq. fjjjj), and ulcers. 
It is doubtful if it possess the power to lessen the urinary albu- 
men in Bright's disease. Dose, gr. j— iv, in pill, occasionally 
repeated. Troches of tannic acid are made by rubbing together 
tannic acid, powdered sugar and powdered tragacanth, and form- 
ing a mass with orange-flower water ; each troche contains of 
tannic acid gr. j. Ointment of ta?inic acid (^unguentum acidi tan- 
nici) is made by rubbing up 10 parts of tannic acid with 90 parts 
of benzoinated lard. 

ACIDUM GALLICUM GALLIC ACID. 

This principle is found in many of the vegetable astringents, 
but less uniformly than tannic acid, and is probably the result 
of changes which the latter has undergone. It is prepared by 
exposing a mixture of nutgall and animal charcoal in water to 
the air, in a warm place, for a month, when the tannic acid is 
gradually converted into gallic acid by the absorption of a mole- 



ASTRINGENTS NUTGALL. I 8 I 

cule of water, since the most recent experimenters (H.,SchifT, 
Sac and Lowe) have shown that tannic acid is the anhydride of 
digallic acid ; it is purified by being boiled in water and filtered 
through animal charcoal. It is also prepared by boiling pow- 
dered nutgall in dilute sulphuric acid (Liebig). If the conver- 
sion into gallic acid be completed there will be no turbidity on 
the addition of solution of isinglass. Gallic acid (HC 7 H 5 05.H 2 0) 
is distinguished from tannic acid by not coagulating albumen or 
gelatin; and it unites with organic and inorganic bases to form 
gallates. For internal use, gallic acid is preferable to tannic, 
since it does not coagulate albumen. It occurs in small, silky, 
nearly colorless crystals, having a slightly acid and astringent 
taste, and is soluble in boiling water, and slightly so in cold 
water. 

Effects and Uses. — Gallic acid is an astringent, of doubtful 
value, which has been extensively employed in hemorrhagic 
disorders, as uterine hemorrhage, hemoptysis, hematuria, bloody 
diarrhoea, etc. But, according to Stockman (loc. cit) it has no 
other action than that of a weak organic acid, and only dimin- 
ishes the alkalinity of the blood. Sodium gallate is without 
effect on the caliber of the vessels. Both tannic and gallic 
acids have been employed to diminish the quantity of albumen 
in chronic Bright's disease, but the proof of their utility in 
this condition is by no means conclusive. Gallic acid has but 
feeble local astringent powers, and is probably converted into 
tannic acid in the blood. Given by the stomach, it is more 
efficacious than the latter acid. It may be given in doses of 
gr. ij-v, in pill, every two or three hours. The ointment contains 
10 per cent, of gallic acid with benzoinated lard. 

GALLA NUTGALL. 

Nutgall is an excrescence found upon Quercus lusitanica, 
var. infectoria, the Gall Oak (Nat. Ord. Cupuliferse), a small tree 
or shrub of Asia Minor. The gall-nuts are produced by the 
puncture of the buds by a fly (Cynips quercusfolii or Diplolepis 
gallce tinctorice) to form a nidus for its eggs. This occasions an 
irritation and flow of juices to the part, resulting in the formation 
of a tumor around the larvae, which, on attaining maturity, per- 
forate the gall and escape. Galls are produced chiefly in Syria 



I 82 



MATERIA MEDICA NEUROTICS. 



and Asia Minor, and are imported from the Levant. They are 
brought also from Calcutta, being collected to some extent in 
India. Galls are spherical, about the size of a hickory-nut, with 
small tubercles on their surface. The best are bluish or black 
externally and grayish within, without odor, and of a very 
astringent, bitter taste. They yield their properties to both 
water and alcohol, but best to the former, and contain tannic 
acid, 50 to 60 per cent., and gallic acid, 3 per cent. ; mucilage, 
sugar, etc. White galls are collected after they have been per- 
forated by the insect, and are inferior in astringency, containing 
only 30 per cent, of tannic acid. 

Effects and Uses. — Galls are powerfully astringent, but are not 
much used internally. In the form of infusion or decoction they 
are employed as enemata in diarrhoea and dysentery, and also 



Fig. 13. 




QUERCUS INFECTORIA (NUTGALL). 

as gargles. Dose of the powder, gr. x-xx. The tincture (20 
per cent., in glycerin and diluted alcohol) may be given in the 
dose of f5j-iij, but it is used chiefly as a chemical test. The 
ointment (10 parts to benzoinated lard 90 parts) is a favorite 
application in hemorrhoids, and may be advantageously com- 
bined with opium (5ss to ointment Sj). 



CATECHU. 

Catechu, formerly called Terra japonica, is an extract of the 
wood of Acacia Catechu, a small prickly tree of India {Nat. Ord. 
Leguminosae). Twelve or fifteen varieties of the drug are 
described by pharmacologists ; but it is usually met with in the 
shops in masses of various shapes and sizes, of a rusty-brown 
color externally, and varying internally from a reddish or yel- 



ASTRINGENTS KINO. 1 83 

lowish-brown to a dark-brown color. The best is of a dark 
color, and is easily broken into small angular fragments, with a 
smooth, glossy surface, bearing some resemblance to kino. It 
is without smell, and has an astringent, bitter taste. It contains 
about 50 per cent, of catechn-tannic acid, which strikes a greenish- 
black precipitate with ferric salts, and about 30 per cent, of an 
acid principle, called catechin, to both of which it owes its peculiar 
properties ; also, in small amount, quercitrin and catechu-red. 

Effects and Uses. — This is one of the most powerful and valu- 
able of the vegetable astringents, possessing also mild tonic 
properties. It is much employed in combination with other 
remedies in diarrhoea, dysentery, and hemorrhages, and is best 
administered half an hour before meals. It is a good deal used 
in relaxed conditions of the mouth and throat, to relieve the 
hoarseness of public speakers, also in aphthous ulcerations of the 
mouth and spongy affections of the gums. Topically, it is em- 
ployed as a styptic, and in solution as an injection in gonorrhoea 
and gleet. Dose of the powder, gr. x to 5ss in bolus or emulsion. 

Of the compound tincture (12 parts with cinnamon 8 parts in 
diluted alcohol to make 100 parts), the dose is f5j-iij. The 
troches each contain of catechu, gr. j, with sugar, tragacanth, and 
orange-flower water. 

KINO. 

The term Kino is applied to the products of several trees. 
Five varieties are known. 1. East India kino, which is the 
most common, and is the inspissated juice of Pterocarpus 
Marsupium (Nat. Ord, Leguminosae), a lofty tree of Malabar. 

2. African kino, the original variety introduced into Europe, 
but not now met with ; obtained from Pterocarpus erinaceus. 

3, Botany Bay kino, the concrete juice of Eucalyptus resinifera 
(Nat. Ord. Myrtaceae), a large tree of Australia. 4. Bengal or 
Palas kino, from the Butea frondosa (Nat. Ord. Leguminosae). 
5. Jamaica and Caraccas kino, the extract of the wood and bark 
of Coccoloba uvifera, or Seaside Grape (Nat. Ord. Polygonaceae), 
a small tree of South America and the West Indies. 

East India kino is met with in small, angular, shining frag- 
ments, of a dark-brown or reddish-brown color, brittle, without 
smell, but with a very astringent taste. It contains kino-tamiic 
acid, kino-red, pyrocatechin (a trace), and kinoin. 



184 MATERIA MEDICA NEUROTICS. 

South American kino comes in large masses, externally very- 
dark, and internally of a deep reddish-brown color. 

Jamaica kino resembles the last, but is contained in large 
gourds. 

Effects and Uses. — Kino is a powerful astringent, and is much 
used in diarrhcea, chronic dysentery, leucorrhcea, gonorrhoea, 
and hemorrhages. Externally, it is employed as a styptic, and 
as a stimulant to indolent ulcers. Dose of the powder, gr. x- 
5ss ; of the tincture (10 parts, glycerin 15 parts, alcohol and 
water to make 100 parts of tincture), f5j-ij may be given, and it 
is frequently added to chalk mixture in diarrhcea. 

KRAMERIA. 

Krameria or Rhatany is the root of Krameria triandra and 
of K. tomentosa (Nat. Ord. Polygaleae), shrubs of Peru, Bolivia, 
and New Granada. It occurs in woody cylindrical pieces, of the 
thickness of a goose-quill to twice that size — many radicles 
being often united to a common head. They have a dark, red- 
dish-brown bark and a tough central ligneous portion, of a 
lighter red color. They are without smell, but have a very 
astringent, slightly bitter and sweetish taste, which is much 
stronger in the cortical than the ligneous portion ; and hence 
the smallest pieces should be preferred, as they contain the most 
bark. Rhatany yields a large proportion of kramero-tannic and 
rhatanic red. It imparts its properties to both cold and boiling 
water, but more fully to alcohol. 

Effects and Uses. — Rhatany is powerfully astringent, with some 
tonic properties. It is much used in the treatment of diarrhcea, 
dysentery and hemorrhages, and as an enema. Trousseau 
strongly recommends its use in fissure of the anus and in 
tenesmus due to chronic dysentery or hemorrhoids ; it is also 
used in hemorrhoids and leucorrhcea. The powdered extract is 
an ingredient in many tooth-powders, and the tincture is used 
also as an astringent mouth-wash. Dose of the powder, gr. 
xx-xxx ; watery extract, dose, gr. x-xv ; fluid extract, dose, f5ss-j ; 
tincture (20 per cent.), dose, f5j-ij ; and syrup, dose, f3j— iv. The 
troches each contain gr. ij of Krameria with sugar, tragacanth 
and orange-flower water. 



ASTRINGENTS WHITE OAK. 1 85 

H^MATOXYLON. 

Logwood, or Campeachy wood, is the heart-wood of Hae- 
matoxylon campechianum {Nat. Ord. Leguminosae), a medium- 
sized tree of Campeachy and other maritime parts of tropical 
America, and now naturalized in the West Indies. The portion 
used in medicine, and also as a dye, is the heart-wood, from 
which the bark and white sap-wood are removed previous to 
exportation. It is imported in billets of different sizes, of a dark 
color externally and a deep red internally ; in the shops it is kept 
in chips or raspings. It has a sweetish, astringent taste and a 
feeble, not unpleasant, smell. It contains tannic acid, a coloring 
principle called hcematein, licematoxylin (C 16 H 14 6 ), resin, etc. 

Effects and Uses. — It is a mild astringent, useful in chronic 
diarrhoea and dysentery, and particularly well adapted to the 
weakened condition of the bowels which follows cholera infan- 
tum. Mothers should be told that the stools of infants taking 
hsematoxylon will stain their napkins red. It is also much 
employed in the diarrhoea of phthisis. It is given in decoction 
in the dose of fSj to adults, and f5j to children ; or watery extract, 
in the dose of gr. x-xxx in solution. 

QUERCUS ALBA WHITE OAK. 

The barks of several species of American oaks possess astrin- 
gent properties, and are probably to be found in the shops, but 
the only officinal variety is Quercus alba, White Oak {Nat. Ord. 
Cupuliferse). The inner bark is the portion used, but the leaves 
and acorns also are astringent. White-oak bark is distinguished 
by its whitish color. When prepared for use, it is deprived of 
its epidermis, and is of a light-brown color and fibrous texture, 
with an astringent and bitterish taste. Water and alcohol extract 
its virtues, which depend mainly on the presence of querci-tannic 
acid (C^H^O^), tannin, oak-red, etc. . - , ■ ^ 

Effects and Uses.- — A decoction of white-oak bark is a good 
remedy in diarrhoea and hemorrhoids, and is employed as an 
enema in hemorrhoids and prolapsus, and fissure of the anus, as 
a gargle in relaxation of the uvula, and as an injection in leucor- 
rhcea without inflammation and where the discharge is profuse, 
in checking which the mineral astringents have failed. It, how- 
ever, stains the linen. 



1 86 



MATERIA MEDICA NEUROTICS. 



It is also used on a cotton tampon in descensus uteri, recto- 
cele or cystocele when these conditions are due to relaxation 
of the parts, or when operative interference is not justifiable. Of 
decoction of white-oak fgij may be taken frequently. 



Fig. 14. 




GERANIUM MACULATUM. RHIZOME. 



GERANIUM. 

One of the most powerful of the indigenous astringents is Ge- 
ranium maculatum, Crowfoot, or Cranesbill {Nat. Ord. Gerania- 
ceae), a perennial herbaceous plant, growing- in moist woody 
situations, with an erect stem one to two feet high, pale-green, 



ASTRINGENTS — HAMAMELIS. 1 87 

mottled leaves, and large purple flowers, which appear in April 
and May. The part used is the rhizome, which should be col- 
lected in the autumn. This, when dried, occurs in wrinkled, 
rough pieces, from a quarter to a half an inch in thickness, fur- 
nished with slender fibres, of a dark-brown color externally and 
a pale flesh-color within. It has an astringent but not bitter 
taste and no smell, and contains tannic and gallic acids with 
mucilage. 

Effects and Uses. — This ^is an excellent simple astringent, 
agreeing very well with the stomach, and might be advantage- 
ously substituted for more expensive foreign drugs. It may be 
used internally to fulfill the indications of kino, rhatany, etc., in 
bowel complaints and hemorrhages, and topically as an enema, 
gargle, injection, etc. It is also a styptic. Dose, in powder, gr. 
x to xx ; of the decoction, f gj-ij may be given. A decoction in 
milk is given to children. The fluid extract may be given in 
doses of f3ss-j. 

HAMAMELIS. 

Hamamelis virginica, or Witchhazel (Nat. Ord. Hamamelaceae), 
is a shrub, from six to ten feet high, growing in the damp woods 
of the United States and Canada. The leaves are the officinal 
part, and should be collected in autumn. They are bitter and 
astringent. The bark may also be used. Hamamelis contains 
tannic acid (8.10 per cent.), a bitter principle not yet accurately 
determined, etc. 

Effects and Uses. — Hamamelis is an astringent, and, according 
to Phillips, possesses probably a hemostatic and shrinking power 
over veins, especially those of the skin and mucous membranes. 
It has been used with success in passive hemorrhages, in 
hematemesis, hemoptysis,* and hematuria. It is beneficial in 
hemorrhoids,! checking the bleeding and reducing the size of 
the enlarged veins. For this purpose it may be given internally 
and used as an injection, beginning with 5j to water §ij, and 
gradually increasing the strength. The injection should be 
taken morning and evening, and retained, and it must be con- 
tinued for some time (H. M.). It is also recommended in 



* Bull. Gen. de Thkrap., cvi, p. 193. Dujardin-Beaumetz. Sur Hamamelis 
Virginica. f Ibid. 



I 88 MATERIA MEDICA NEUROTICS. 

varicocele, and locally in inflammations and congestions. The 
fluid extract is the only officinal preparation ; dose, f5ss-j. 

The following vegetable astringents deserve notice, though 
less frequently employed than the foregoing : — 

Rosa Gallica {Red Rose) ; Rosa Centifolia {Pale Rose) 
{Nat. Ord. Rosaceae). The petals of these two species of rose 
are officinal, but those of almost every other species of culti- 
vated rose may be employed for the same purpose as Rosa 
centifolia, which is not astringent. The red rose is a mild as- 
tringent. The fluid extract is used as a flavoring ingredient in 
gargles and mouth washes, to disguise the taste of other medi- 
cines, as Glauber or Epsom salts. The confection is used as a 
basis for pills. Mel Rosce {Honey of Rose), made with diluted alco- 
hol and clarified honey, is used as an addition to gargles ; the 
syrup is added to mixtures. The pale rose is slightly laxative. 
Aqua Rosce {Rose Water), distilled from the pale rose, is much 
employed in collyria, etc. Unguentum Aquce Rosce {Ointment of 
Rose Water) is made by melting together oil of almond 50 parts, 
spermaceti 10 parts, white wax 10 parts, and then gradually 
adding rose-water 30 parts ; this is a very soothing application, 
much used under the name of cold cream. 

Rhus Glabra {Sumach). This is an indigenous shrub grow- 
ing to the height of from four to twelve feet, having a somewhat 
bent stem " divided into straggling branches, covered with 
smooth light gray or some reddish bark, and imparipinnate 
leaves " with from twenty-one to thirty-one lance-oblong, pointed, 
and serrate leaflets. The fruit is in " clusters of small crimson 
berries which are subglobular, about one-eighth of an inch in 
diameter, drupaceous, densely haired, containing a roundish- 
oblong, smooth putamen." 

They contain acid calcium and potassium malates, tannin, color- 
ing matter, etc. (Maisch), and are excellent astringents, especially 
valuable as a gargle in aphthae and other forms of sore mouth 
and in pharyngitis, for which purpose the fluid extract maybe 
diluted with two or more parts of water. 

Rubus {Blackberry). The bark of the root of Rubus 
villosus, Rubus trivialis and Rubus Canadensis {Nat. Ord. 
Rosaceae), the former (the common American Blackberry) an 
erect, prickly shrub, and the two latter (Dewberries) creeping 



ASTRINGENTS PREPARATIONS OF LEAD. I 89 

briers, are very efficient mild astringents, which have been used 
with excellent effect in bowel complaints, especially those of 
children. The astringency resides principally in the cortical 
portion, and hence the smallest roots should be preferred. The 
fluid extract may be given in doses of f 5j-ij ; the syrup is made 
by adding 20 parts of the fluid extract to syrup 80 parts ; dose, 
foss. 

Castanea {Chestnut). The leaves of the Castanea vesca 
{Nat. Ord. Cupuliferae), a stately tree indigenous to both hemi- 
spheres, are officinal. They should be gathered in the autumn 
while still green. They contain tannin, etc., and are used prin- 
cipally in whooping-cough. Dose of the fluid extract, f"5ss-ij. 

,A large number of vegetable substances, both indigenous and 
foreign, have been used as astringents in addition to those 
enumerated, the astringent principle being the most common 
medicinal property with which plants are endowed. The fore- 
going list comprises the more important. 

mineral astringents. 

plumbi pr^parata preparations of lead. 

Metallic lead is considered inert. The sulphide and sulphate 
are probably also inactive ; but with these exceptions, all the 
compounds of lead possess more or less activity. When applied 
locally in solutions not too concentrated, they coagulate albumen, 
contract the blood vessels, and consequently blanch the tissues, 
but are not absorbed by the skin.* When more highly concen- 
trated solutions are applied, they act as irritants, producing 
inflammation. When administered in therapeutical doses, they 
act as astringents in the alimentary canal, checking secretion and 
causing constipation. Rutherford states that lead acetate is the 
only drug which decreases the secretion of bile without causing 
purgation, and attributes this effect to a direct action on the liver. 
The lead preparations probably enter the blood from the stomach 
as albuminates, and pass directly to the liver, f by which they are 
chiefly eliminated, though a trace may be found in the urine. From 
the intestine they are only absorbed slowly and in small quantity. 
After absorption they irritate the cardiac inhibitory centre and 

* Journal de V Anatomie et de la Physiol., 1873, p. 235. f Ibid. 



I9O MATERIA MEDICA — NEUROTICS. 

at the same time act on the terminal intro-cardiac branches of 
the vagus, thus diminishing the frequency of the cardiac beat 
(which under large doses becomes intermittent), lessening the 
duration of the systolic bruit, while prolonging the diastolic 
bruit, thus producing a diminution in the volume and frequency 
of the pulse.* They also decrease the activity of the secreting 
functions, and frequently arrest sanguineous discharges, both 
natural and artificial. In excessive doses, several of the satur- 
nine compounds are irritant and corrosive poisons, giving rise to 
gastro-enteric inflammation, and sometimes to paralysis, coma, 
and collapse. The toxic dose of lead acetate is 5j— ij, but it is 
rarely fatal, owing to the vomiting it produces. The proper 
antidote is sulphuric acid or some alkaline or earthy sulphate, in 
solution in a large quantity of diluent. The tests for lead are 
sulphuretted hydrogen and a solution of potassium iodide ; the 
former strikes a black and the latter a yellow precipitate with 
soluble lead salts. The editor f has ascertained that sulphuretted 
hydrogen will detect one part of a soluble lead salt in one 
million parts of water. 

When the system becomes impregnated with lead, either from 
the too long-continued use of its preparations medicinally, from 
drinking water drawn through lead pipes, or from exposure to 
its influence in lead factories, etc., a peculiar kind of chronic poi- 
soning is produced, which shows itself by a variety of symptoms. 
The most usual form of lead-poisoning is colic, sometimes termed 
colica Pictonum, and painter's colic, which is characterized by sharp 
abdominal pains, with hardness and depression of the abdominal 
parietes, obstinate constipation, nausea and vomiting. Dr. Ernest 
Harneck, from experiments on the lower animals, concludes that 
colica Pictonum is due to intense excitation of the intestinal 
ganglia by the lead, producing arrest- of peristalsis from spasm 
of the muscular coat, and recommends belladonna or atropine 
as affording speedy relief. According to Bardenhewer, pilocar- 
pine relieves the colic with equal rapidity. Next in frequency is 
lead-arthralgy, in which there are severe pains in the limbs, 
attended by cramps, hardness and tension of the painful parts. 



* Gaz. Hebdom., August, 1883, Curci. 

f Am. J. M. S., October, 1878, C. Biddle, m.d. 



ASTRINGENTS PREPARATIONS OF LEAD. I9I 

Lead-paralysis is another, though less common, variety of the 
disease, and is characterized by a loss of voluntary motion, owing 
to the want of contractility of the muscular fibres of the affected 
parts. It most frequently affects the upper extremities, and the 
extensor rather than the flexor muscles. Occasionally, functional 
disease of the brain is also observed as one of the consequences 
of lead-poisoning. The absorption of lead into the system is 
recognized by a saturnine coloration of the gums, of the mucous 
membrane of the mouth, and of the teeth. In a series of experi- 
ments made by the editor,* the fact was established that the 
emanations from fresh lead paint do not contain lead. It seems 
proven, therefore, that in order to induce saturnine poisoning, 
actual contact is necessary with paint or lead in some form. The 
antidotal treatment of chronic lead-poisoning consists in the 
internal administration of solutions of sulphuric acid and of 
soluble alkaline and earthy sulphates, and in the use of baths of 
potassium sulphide, dissolved in warm water, by which the salts 
of lead, deposited on the skin, are converted into the insoluble 
sulphide. Potassium iodide is employed as an eliminative remedy. 
For lead-colic, a combination of cathartics and opiates has been 
employed ; but the best remedy is alum, in doses of 5j-ij, every 
three or four hours, dissolved in some demulcent liquid. In the 
treatment of lead-palsy, strychnine and electricity may be used, 
but it is a very intractable form of the disease. The use of sul- 
phuric acid lemonade is resorted to, by workmen in lead factories, 
as a preventive of lead-poisoning. Milk has been found also to 
answer the same purpose. By passing a strong solution of potas- 
sium or sodium sulphide, heated to the temperature of 212° F., 
through leaden pipes, the interior surface will become coated 
with an insoluble lead sulphide, and the water distributed through 
them will be free from contamination. 

Therapeutically \ the preparations of lead are employed as 
astringents, sedatives and desiccants. For internal use the ace- 
tate is almost exclusively employed. It is a most valuable 
remedy in hemorrhages, obstinate diarrhoea and dysentery, and 
in the treatment of internal aneurism, from its combined seda- 
tive and astringent influence, and is also very serviceable in 

* Am. J. M. S., October, 1878, C. B. Prize thesis. 



I92 MATERIA MEDICA NEUROTICS. 

fluxes from the mucous membranes, particularly of the bowels. 
Topically, lead-washes are employed to relieve superficial inflam- 
mation, to arrest morbid discharges, and as desiccants. They 
are objectionable, however, as eye-washes, from their often form- 
ing precipitates of lead upon the cornea. 

Plumbi Acetas (Lead Acetate). This salt (Pb2C 2 H 3 2 . 3H 2 0), 
known also as saccharum saturni or sugar of lead, is made by 
immersing lead in distilled vinegar, or litharge in pyroligneous 
or crude acetic acid. It occurs in colorless, needle-shaped crys- 
tals, which effloresce on exposure to the air. They have an 
acetous odor and a sweetish, astringent taste, and are soluble in 
both water and alcohol. The mineral acids and their soluble 
salts, the alkalies and alkaline earths, and vegetable astringents, 
are incompatible with lead acetate. The lead salts are aided in 
their depressing action upon the circulation by prolonged cold, 
ergot and veratrum viride ; in their astringent effect on the tissues 
by the salts of zinc, copper, bismuth and silver ; and in their 
depressing influence on nutrition by mercury, antimony, copper 
and other metals which increase tissue waste. 

Effects and Uses. — The effects of this salt are those of the 
saturnine preparations which have been already described. Its 
medicinal influence is sedative and astringent. In hemorrhages 
it is employed internally, usually in combination with opium. 
This combination is also much resorted to in the treatment of 
diarrhoea, dysentery and cholera, and may be prescribed with 
advantage to arrest the secretion of bronchitis and the night- 
sweats of phthisis. In the cure of internal aneurism the acetate 
is prescribed alone, but with unsatisfactory results. In diarrhoea, 
if there be abdominal pain and frequent serous stools, the ace- 
tate should be combined with opium : Jfy Plumbi acetatis, gr. 
xij ; pulvis opii, gr. vj. M. S. — Ft; pil. no. vij, one after each 
stool. This is equally efficacious in dysentery, but the propor- 
tion of opium should be increased. In yellow fever it is em- 
ployed to check the hemorrhagic condition of the gastric mucous 
membrane. It is a dangerous remedy in chronic diseases, from 
the liability to lead-poisoning, when its administration is long 
continued. As a topical remedy, lead acetate, in aqueous solu- 
tion, is extensively employed to relieve inflammation and diminish 
morbid discharges. Dose, gr. j-ij-viij, two or three times a day. 



ASTRINGENTS PREPARATIONS OF LEAD. 1 93 

When applied to mucous membranes, as in gonorrhoea, the 
strength of the solution may be gr. ss-j or ij to water f§j ; for 
phlegmonous inflammation, 5ij to water Oj. When it is desirable 
to combine opium with lead as an external application, the fol- 
lowing formula will be found a cheap and efficacious substitute 
for " lead-water and laudanum : " Ify Opii pulveris, 5j ; plumbi 
acetatis, §j. S. — Put the powder in a pint of boiling water and 
stir; when cool apply externally on a cloth of several thick- 
nesses. 

Liquor Plumbi Subacetatis {Solution of Lead Subacetate). 
This preparation, frequently termed Goulard's Extract, is an 
aqueous solution of lead diacetate (Pb 3 2 2C2H 3 02), and is made 
by boiling lead acetate and litharge in distilled water. It is a 
colorless liquid which is decomposed on exposure to the air, 
with the formation of insoluble lead carbonate, and occasions a 
dense white precipitate with solution of gum. In other respects 
it resembles a solution of lead acetate. 

Uses. — It is chiefly employed, diluted, to promote the reso- 
lution of external inflammation and arrest discharges from sup- 
purating, ulcerated and mucous surfaces. It is advantageously 
employed in the moist varieties of eczema, and also in acute 
cases accompanied with much heat. In orchitis, solution of the 
subacetate applied frequently to the scrotum, on lint, together 
with absolute rest and support of the parts, constitutes an effi- 
cient plan of treatment. The officinal dilution is liquor plumbi 
subacetatis dilutus, commonly known as lead-water, and consists 
of solution 3 parts to distilled water 97 parts. Ceratum plumbi 
subacetatis, or Goulard's Cerate, is made by mixing Goulard's 
extract (20 parts) and camphor cerate (80 parts) ; it is an admira- 
ble dressing to excoriated and blistered surfaces, burns and 
scalds. Linimentum plumbi subacetatis {liniment of lead subacetate) 
is made by mixing cotton-seed oil with Goulard's extract. 

Plumbi Iodidum {Lead Iodide) (Pbl 2 ) is made by the double 
reaction of solutions of lead nitrate and potassium iodide. It is 
a bright-yellow, heavy, inodorous powder, volatilizable by heat, 
sparingly soluble in cold water, but more soluble in boiling water. 
It may be given internally in the dose of gr. iij— iv, or more, in 
pill ; but it is principally employed externally in the form of oint- 
ment (10 parts to benzoinated lard 90 parts). 
13 



194 MATERIA MEDICA NEUROTICS. 

Plumb i Nitras (Lead Nitrate) (Pb2N0 3 ), made by dissolving 
litharge in diluted nitric acid, occurs in white, nearly opaque, 
octahedral crystals, permanent in the air, of a sweet, astringent 
taste, and soluble in water and alcohol. It may be given inter- 
nally, as a sedative astringent, in doses of gr. %—), twice or thrice 
daily, in pill or solution. But its principal use is as a topical 
agent in the treatment of wounds, ulcers, and cutaneous affec- 
tions. Dr. Fordyce Barker recommends it as an application to 
fissured nipples (gr. x in glycerin §jj), and the breast must be care- 
fully washed before nursing. Ledoyen's Disinfecting Fluid is a 
solution of lead nitrate 5j in water foj. 

Plumbi Oxidum (Lead Oxide) (PbO), or Litharge, is prepared 
by blowing air through melted lead, and is obtained also in the 
process for extracting silver from argentiferous galena^. It 
occurs in minute yellowish or orange-colored scales, insoluble 
in water, and is never employed internally. It is sometimes 
sprinkled over ulcers, but its chief use is in the preparation of 
cmplastrum plumbi, or lead-plaster (called also diachylon), a lead- 
soap, which is made by boiling litharge with olive oil in water, 
and is, chemically, a mixture of lead oleate and margarate. It 
serves as a basis for most of the other plasters. Unguentum 
diachylon (diachylon ointment) consists of lead plaster 60 parts 
melted with olive oil 39 parts, and incorporated when partly cool 
with oil of lavender 1 part. This is an excellent soothing appli- 
cation in chronic eczema with scales and infiltration, after the 
parts have been cleansed with sapo viridis, laid on with muslin. 
Emplastnim saponis (soap-plaster), made by rubbing up soap with 
lead-plaster, is an excellent discutient. 

Plumbi Carbonas (Lead Carbonate), or White Lead, is manu- 
factured in this country by exposing lead to the fumes of vinegar 
or acetic acid, carbonic acid being derived from the fermentation 
of tan, in which the pots containing lead are packed ; lead oxy- 
acetate as formed, is converted into carbonate. It is a white 
powder, without smell or taste, and insoluble in water, and, as it 
occurs in commerce, is a compound of lead carbonate and hy- 
drate (2PbC0 3 .Pb2HO). It is never administered internally, but 
it is employed as a dusting powder — though there is danger of 
its absorption. Unguentum plumbi carbonatis (10 parts to ben- 
zoinated lard 90 parts) is a good application to burns, etc. 



ASTRINGENTS PREPARATIONS OF COPPER. 1 95 

White paint is used for the same purpose, but when applied to a 
large surface it may produce lead-poisoning. 

CUPRI PR^PARATA PREPARATIONS OF COPPER. 

Metallic copper is inert. The salts of copper act locally as 
caustics, irritants, and astringents, by their coagulating action 
on albumen ; applied to the sound skin they produce but little 
effect. They also constringe the tissues and lessen the blood 
supply to a part. In the blood they probably exist as albu- 
minates. Some observers have noted a gain in flesh, in animals 
and man, after a course of copper. Taken too long they give 
rise to symptoms similar to plumbic poisoning, viz., constipation, 
paralysis, etc. When exhibited in small doses, they seem to 
exert a corroborant influence over the cerebro-spinal system, 
and are occasionally employed to fulfill the indications to which 
tonics are applicable, as in neuralgia. In larger doses, they pro- 
duce gastric irritation and act as emetics. Lauder Brunton * has 
ascertained experimentally that copper sulphate injected into the 
blood likewise causes retching and vomiting, probably brought 
about, he thinks, by. irritation of the stomach and intestines, 
which is reflected to the vomiting centre of the medulla. In 
excessive doses, they produce gastro-intestinal inflammation and 
disorder of the nervous system ; death, in fatal cases, is usually 
preceded by convulsions, paralysis, and delirium. Copper is 
eliminated by the liver, intestines, and kidneys. Its salts are 
employed therapeutically, both as external and internal reme- 
dies ; externally as stimulants, astringents, styptics, and caustics ; 
internally as emetics, astringents, and tonics. In cases of poisoning 
from the cupreous compounds, the best antidote is albumen, as 
white of eggs, milk, wheaten flour. The potassium ferrocyanide 
is also very efficacious, forming with the cupreous compounds 
an insoluble copper ferrocyanide. This salt (which throws down 
a mahogany-colored precipitate), ammonia (which strikes an 
azure -blue color), sulphuretted hydrogen, or ammonium sulphide 
(which throws down a deep brownish-black precipitate), and 
metallic iron (on which metallic copper is deposited from a 
cupreous solution), are tests for the soluble salts of copper. 

* St. Bartholomew 's Hosp. Reports, XII, p. 145. 



I96 MATERIA MEDICA NEUROTICS. 

Cupri Sulphas {Copper Sulphate). This salt, known as blue 
stone and blue vitriol, is obtained by roasting the native sulphide, 
or by combining cupric oxide (CuO) and sulphuric acid. It is 
cupric sulphate (CuS0 4 .5H 2 0). It occurs in fine prismatic, blue 
crystals, which, by exposure to the air, effloresce slightly and 
become covered with a greenish-white powder. It has a styptic, 
metallic taste, is entirely soluble in water, but insoluble in alco- 
hol. As an astringent, it may be given in doses of gr. ^ to j, 
or more, in pill, repeated so as not to occasion vomiting, and 
will be found extremely valuable in the treatment of chronic 
diarrhoea, dysentery, and enteritis. It is also used as an anti- 
dote to phosphorus. As an emetic, the dose is gr. iij to v. 
Externally, it is used as a mild escharotic to granular lids, 
mucous patches, and ulcers, and in solution to arrest hemor- 
rhages, muco-purulent discharges, as gonorrhoea. In gonor- 
rhoea gr. y 2 -) to water f5j is a suitable strength to begin with. 

Cupri Acetas (Copper Acetate) (CU22C2H3O2.H2O) occurs in 
deep, bluish-green or green rhombic prisms. The dose is gr. 
\ to gr. \. It resembles the sulphate in its effects and uses. 

ZINCI PR^PARATA PREPARATIONS OF ZINC. 

Zinc in its metallic state is inert. Its compounds are very 
analogous in their effects on the system to those of copper, but 
are less energetic. Topically some of the zinc salts (nitrate, 
chloride) act as powerful caustics, by reason of their affinity for 
water and power of coagulating albumen. The soluble zinc 
salts (sulphate, chloride) are readily absorbed, and probably 
exist in the blood as albuminates, while the insoluble salts 
(oxide, carbonate) are slowly taken up by the blood. Zinc is 
eliminated from the system by the bile, intestines, and urine. 
The test for soluble zinc salts is ammonium sulphide, which 
throws down a white sulphide (the only white sulphide met 
with). The zinc preparations are employed topically as caustics, 
astringents, and dcsiccants\ and internally , as, tonics, astringents, 
and, in large doses, as emetics. In cases of poisoning (rare), 
albumen, demulcents, and opiates are to be administered. 

Zinci Sulphas {Zinc Sulphate) (White Vitriol) (ZnS0 4 .7H 2 0) 
is prepared by dissolving zinc in dilute sulphuric acid. It occurs 
in small colorless, transparent, prismatic crystals, resembling 



ASTRINGENTS PREPARATIONS OF ZINC. 1 97 

those of magnesium sulphate. They have a metallic, astringent 
taste, are soluble in water and insoluble in alcohol, and produce 
their astringent effect by condensing the tissue and contracting 
the blood vessels. Internally, it is chiefly used in chorea, and 
by Hammond in large doses (gr. ij— xx, t. d.). Dose, as a tonic 
and astringent, gr. j to v ; as an emetic (acting by gastric irrita- 
tion), it is the promptest and safest that can be given in cases of 
narcotic poisoning, in the dose of gr. x-xx, well diluted in water. 
Externally, it is much used as a caustic, and in solution as a 
collyrium ; or in gonorrhoea, in the strength of gr. j — ij to water 
fSj ; in otitis, gr. v. to water f oj. 

Zinci Oxidum (Zinc Oxide) is made by roasting zinc in the 
air. This is an impure form, known as Commercial Zinc Oxide 
(Zinci Oxidum Venale), sometimes called tutty. A purer form is 
obtained by exposing precipitated zinc carbonate to heat, which 
expels the carbonic acid and water. It is a yellowish-white powder 
(ZnO), insoluble in water but soluble in diluted sulphuric and 
hydrochloric acids. It is occasionally used in the treatment of 
epilepsy; dose, gr. ij, in pill, gradually increased. It is now 
mostly employed externally as a dusting powder, or in the form 
of ointment (20 parts to benzoinated lard 80 parts). 

Zinci Acetas (Zinc Acetate) is made by heating commercial 
zinc oxide in a solution of acetic acid and distilled water, and 
occurs in white micaceous crystals (Zn2C 2 H 3 02.2H 2 0), very 
soluble in water, and efflorescent in dry air. It is used chiefly 
as a topical astringent in ophthalmia, gonorrhoea, or leucorrhcea 
(5j to tepid water Oj) in the proportion of gr. ij to vj, or more, 
to water, f§j. As an injection in the third stage of gonorrhoea, 
it was the remedy preferred by Bumstead,* and its strength 
should be regulated just short of irritation of the urethra. 

Zinci Carbonas Pr^ecipitatus (Precipitated Zinc Carbonate) is 
obtained by the double reaction of solutions of zinc sulphate 
and sodium carbonate. It is a soft white powder, a mixture of 
carbonate and hydrate (ZnC0 3 ) 2 .3Zn(HO),, similar in its action 
to the oxide, but is chiefly used as a dusting powder, and to 
make a mild astringent and desiccant cerate (oj to ointment §v). 

Liquor Zinci Chloridi (Solution of Zinc Chloride) may be 

* " Venereal Diseases," 1879, p. 59. Bumstead and Taylor. 



I90 MATERIA MEDICA NEUROTICS. 

used to disinfect water-closets and sinks. The evaporation of 
this solution yields 

Zinci Chloridum {Zinc Chloride) (ZnCl 2 ), a whitish-gray, semi- 
transparent, deliquescent mass, having the softness of wax, and 
soluble in water, alcohol, and ether. Its local action is that of a 
powerful caustic, and it is one of the best escharotics that can 
be exhibited, to produce healthy granulations in malignant or 
indolent ulcers, especially in lupus. It may be used as a lotion 
in the strength of gr. ij to fSj of water, or dissolved in a little 
alcohol, or in the form of paste, made with one part of the salt 
to two or four of flour. A solution of zinc chloride is employed 
as an antiseptic, and is also injected into the blood vessels of 
anatomical subjects to preserve them for dissection. Burnett's 
Disinfecting Fluid is a solution of about gr. cc in water f§j. 

Zinci Iodidum {Zinc Iodide) (Znl 2 ) is made by digesting an 
excess of zinc with iodine diffused in water. It occurs in the 
form of a white deliquescent mass, or of fine needles, of a metallic, 
styptic taste, very soluble in water. Externally, it is a most valu- 
able local stimulant and escharotic, equal if not superior in effect 
to the chloride, and is much used. 

Zinci Valerianas (Zinc Valerianate) (Zn2C 5 H 9 2 .H 2 0) is pre- 
pared by the double reaction of sodium valerianate and zinc sul- 
phate. It occurs in white, pearly scales, having a faint odor of 
valerianic acid, and a metallic, styptic taste. It dissolves in 100 
parts of water and 40 of alcohol. Used in epilepsy and nervous 
affections, in the dose of gr. i-ij, repeated several times a day. 

ARGENTI PR.EPARATA PREPARATIONS OF SILVER. 

In the metallic state, silver is wholly inert. The only prepara- 
tion which is extensively employed is 

Argenti Nitras {Silver Nitrate). This salt (AgN0 3 ) is ob- 
tained by dissolving silver in diluted nitric acid. It is anhydrous, 
and occurs in transparent, colorless, shining, heavy, rhombic 
plates, which have a strongly metallic and bitter taste, are wholly 
soluble in distilled water, and become blackened by the action 
of light in the presence of organic matters. Its solution yields 
with hydrochloric acid or sodium chloride a white precipitate, 
entirely soluble in ammonia. 

Physiological Effects. — The topical action of silver nitrate to 



ASTRINGENTS PREPARATIONS OF SILVER. 1 99 

mucous membranes is that of a caustic, by reason of its coagula- 
ting action on albumen. This action does not extend deeply, 
since a superficial protecting pellicle is formed. When mois- 
tened and applied to the skin, a white stain is formed, which 
soon becomes black on exposure to light, by reduction of the 
silver to the metallic state. Internally. — Nervous system : in 
animals, hypodermic injections of silver hyposulphite and albu- 
minate have caused paraplegia. In small doses, tetanic excite- 
ment, and in toxic, convulsions, were produced. On man the 
silver salts have caused vertigo, loss of memory and nervous 
depression. The effects of silver on the nervous system are cen- 
tric and not peripheral. Circulation : the intravenous injection 
of the silver salts impairs the coagulability of the blood, which is 
found to be dark and pitchy in color. Other symptoms noted 
by this method were probably due to the production of embo- 
lism and thrombosis. The silver salts do not exert a toxic influ- 
ence on the heart. They have a metallic, styptic taste. Small 
doses (oxide, gr. j£, nitrate, gr. J/£) may be taken with con- 
siderable impunity by the stomach. But, in excessive quantity 
(of nitrate gr. iij-v), it may occasion gastro-enteric irritation, 
with disturbance of the nervous system ; and in these cases the 
antidote is common salt (sodium chloride), or any inert chloride, 
which produces, when in contact with the nitrate, sodium nitrate 
and silver chloride. Silver nitrate has been thought always to 
undergo conversion into a chloride in the stomach ; but more 
probably it unites with albuminous matters, which render it 
soluble. In medicinal doses, it has a corroborant action on the 
nervous system; and, after prolonged use, since its elimination 
takes place slowly, produces a peculiar indelible blueness or slate 
color of the true skin (argyria), due to a deposition of the metal 
in the tissues. This, it has been asserted, is preceded by a' 
peculiar blue line on the gums, resembling that produced by 
lead poisoning. Prolonged use of the silver salts (in animals) 
causes a marked loss of weight. Elimination takes place by 
means of the bile, kidneys (chiefly) and intestines.* 

Medicinal Uses. — Internally, silver nitrate has been employed 

* Journal de F Anatomie el de Physiologie, 1873, P- 2 %9- 



200 MATERIA MEDICA NEUROTICS. 

in the treatment of epilepsy, but it is much inferior to the bro- 
mides in the treatment of this intractable affection ; and its effect 
in discoloring the skin is an objection to its protracted use. It is 
used also successfully in locomotor ataxia, being especially 
extolled by Rosenthall, Charcot, and others, in the dose of gr. y£ y 
t. d. ; but in this disease the galvanic current, in addition to medi- 
cines, renders important aid. In gastric ulcer and chronic gas- 
tritis it is also efficacious in small doses in pill form, after the 
stomach is afforded rest by liquid diet, preferably with milk. As 
an astringent in chronic dysentery and diarrhoea, combined with 
opium its exhibition may prove serviceable. But it is as an external 
agent that it is most resorted to. It is one of the best applica- 
tions that can be made to inflamed mucous membranes, and, 
either in the solid form or in solution, it is employed in every 
variety of inflammation of this tissue. It is also extensively used 
to produce healthy granulations in wounds and ulcers, to arrest 
the progress of erysipelatous inflammation and variolous pustules, 
in porrigo and other skin diseases. The strong injections of 
silver nitrate formerly used to abort acute gonorrhoea are now 
rarely resorted to. In this disease, either of the male or female 
urethra, the best results are obtained by using solutions of the 
strength of gr. %'- \ to water foj, care being taken to avoid stain- 
ing the clothing with it. As a collyrium it is contra-indicated 
when ulcer of the cornea exists, for fear of forming an opacity. 
If a strong collyrium be used (gr. v-x-fSj), in uncomplicated con- 
junctivitis for the relief of which it is an excellent application, 
the effect on the conjunctiva should be counteracted by flushing 
it out with weak solution of salt and water, or even with cold 
water alone. Silver nitrate stains can be removed by moistening 
the spot with tincture of iodine and then washing it with solution 
'of sodium hypophosphite. It may be used to destroy the virus 
of poisoned wounds, but its action as a caustic is too superficial 
to be of much service for this purpose. 

Administration. — The dose of silver nitrate internally is gr. \ y 
gradually increased to gr. \ or j, t. d., in pill, and given soon 
after a little light food has been taken. For external use, solu- 
tions are made of various strengths, from gr. ij-5ss or more in fsj 
of distilled water. An ointment is also employed. 



ASTRINGENTS PREPARATIONS OF BISMUTH. 201 

Argenti Nitras Fusus {Moulded Silver Nitrate — Lunar 
Caustic}. For external use, in the solid form, silver nitrate is 
melted and poured into small moulds. 

Argenti Nitras Dilutus (Diluted Silver Nitrate) consists of 
50 per cent, each of silver nitrate and potassium nitrate. It is 
used externally. 

Argenti Oxidum {Silver Oxide) (Ag 2 0) is obtained by adding 
solution of potassa to a solution of silver nitrate. It is a taste- 
less, olive-brown powder, very slightly soluble in water. Its 
action and applications are analogous to those of the nitrate, and 
it is considered to be free from liability to discolor the skin. 
Dose, gr. ss-j, twice or thrice daily in pill. 

Argenti Iodidum (Silver Iodide) (Agl) may be used in gastric 
and uterine affections instead of the nitrate. It is also said to 
have some alterant effects. Dose, gr. j-ij. 

BISMUTHI PR^PARATA PREPARATIONS OF BISMUTH. 

Metallic bismuth is inert. The salts are very insoluble, but 
to a slight extent are absorbed and eliminated * slowly, as 
bismuth has been found in the urine,f blood, etc., after their 
administration. The unabsorbed residue, passing down the ali- 
mentary canal, is converted into a sulphide and colors the stools 
black. 

Bismuthi Subnitras (Bismuth Subnitrate). This salt is pre- 
pared by forming bismuth nitrate by dissolving bismuth in diluted 
nitric acid, suitable means at the same time being taken to get 
rid of arsenical contamination, as metallic bismuth generally 
contains arsenic. Bismuth subnitrate, known as pearl white and 
magistery of bismuth (BiON0 3 .H 2 0), is a white, inodorous, taste- 
less powder, insoluble in water. Its medical properties are tonic, 
sedative and astringent. It is used chiefly to allay nausea and 
check vomiting in chronic affections of the stomach, as ulcer, in 
which gr. xv-xx should be given t. d., to relieve the pain of gas- 
tralgia, and also as an astringent in subacute and chronic diar- 
rhoea. As bismuth exerts its astringent influence on the intestinal 
tract by a local protective action, in the diarrhoea of adults it 

* Journal de V Anatomie et de la Physiologie, 1 873, p. 243. 
f Transactions Am. Neurological Association, 1883, p. 23. 



202 MATERIA MEDICA NEUROTICS. 

may be given, advantageously, in large doses (5ss— j), to be taken 
one hour before each meal. 1 It is particularly useful in any form 
of diarrhoea where the stools contain mucus ; and acute cases 
of diarrhoea occurring during the summer season are frequently 
benefited by it also. The following combination is of great 
service : 1^ Morphinse sulphatis, gr. y 2 -) ; bismuthi subnitratis, 
5j— ij ; sodii bicarbonatis, 5j ; sacchari lactis (seu pulveris cinna- 
momi), 5ij. M. et div. in chart, xii. Sig. — One powder after each 
alvine dejection. It is often advantageously given suspended in 
an emulsion of castor oil with laudanum, in these and similar 
complaints. Dose, gr. v-xx, or even 5ss, in powder or pill. 
Externally, it is a good remedy in skin diseases, in the form of 
ointment. The following forms a good antiseptic application in 
the treatment of ulcers : — ty Iodoformi, 5j ; acidi borici, 5y ; 
bismuthi subnitratis, 5iv; petrolati, §ij. M. Sig. — Ft. ungt. It 
is also well combined with camphor as a dusting powder, or 
boracic acid in the treatment of purulent otitis of the external 
auditory meatus. 

Bismuthi Subcarbonas (Bismuth Subcarbonate) — (Bi 2 2 C0 8 . 
H 2 0) — is recommended as a substitute for the subnitrate. It is 
thought to be more readily tolerated by the stomach, and is 
more soluble in the gastric juice, but it is less astringent. Dose, 
gr. v-xx, or even 5ss, in powder or pill. 

Bismuthi et Ammonii Citras (Bismuth and Ammonium Citrate), 
which occurs in glossy, translucent, colorless scales, of a slightly 
acid, metallic, but not disagreeable taste, very soluble in water, 
is a good preparation as an astringent. It is much more 
astringent than the insoluble preparations, but is more irritant ; 
dose, gr.ij. 

The valerianate- (not officinal) has been used in neuralgia; dose, 
gr. ^2-j, several times a day, in pill. The test for a soluble salt of 
bismuth is a piece of paper wetted with a solution of potassium 
sulphocyanide, and dried, which will produce a yellow spot at 
the point of contact. 

cerii oxalas — cerium oxalate. 
This salt (Ce^CsO^s.CjHiO) is usually made by adding a solu- 
tion of ammonium oxalate to any soluble salt of cerium, and is 
obtained also from the mineral cerite. It occurs as a snow-white, 



ASTRINGENTS ALUM. 203 

granular powder, inodorous and tasteless, insoluble in water, 
alcohol, and ether, but dissolved by sulphuric acid. It resembles 
the salts of bismuth in its effects, and has been deservedly extolled 
in obstinate forms of vomiting, especially the vomiting of preg- 
nancy. In chorea and other neuroses it is also highly recom- 
mended. Its physiological action has not been investigated. 
Dose, gr. j, t. d., or oftener, in pill or suspended in water. The 
cerium nitrate has been also employed, and is more soluble. 
Dose, somewhat less. 

ALUMEN ALUM. 

Alum is a double salt, an aluminium and potassium sulphate 
(K 2 A1 2 4S0 4 .24H 2 0). It is manufactured from aluminous schist, 
and sometimes by the direct combination of its constituents. It 
crystallizes in regular octahedrons ; but is commonly found 
in the shops in large, colorless, transparent crystalline masses, 
without any regular form. It has an astringent and sweetish, 
acid taste ; by exposure to the air it slowly effloresces ; it is solu- 
ble in cold water, and more so in boiling water; and when heated 
it undergoes the watery fusion, swells up, and gives out its water 
of crystallization, and is converted into a white, spongy mass, 
called dried alum. The alkalies and their carbonates, lime solu- 
tion, magnesia and its carbonate potassium tartrate and lead 
acetate are incompatible with alum. It is aided in its action by 
the vegetable and mineral astringents. 

Besides the potassium alum, there are varieties in which the 
potassium is replaced by some other base, as ammonium or 
sodium ; the officinal alum was formerly the aluminium and 
ammonium sulphate, but this has been superseded by potassium 
alum. 

Physiological Effects. — The immediate topical effect of alum is 
that of a powerful astringent, in virtue of a chemical action on 
the tissues. When it is applied to a part in large quantities, 
the astriction is soon followed by irritation; and thus, taken 
internally in excessive doses, it gives rise to vomiting, griping, 
purging, and even inflammation of the gastro-enteric mucous 
membrane. After its absorption it acts as an astringent on the 
system generally, and produces astriction of the tissues and 
fibres, contraction of the capillaries, and a diminution of secre- 
tion, thus producing constipation. It is eliminated chiefly with 



204 MATERIA MEDICA NEUROTICS. 

the faeces. After large doses, Orfila detected it in the urine of 
dogs. Death has resulted in man from dried alum ojss. 

Medicinal Uses. — Alum is employed internally in hemorrhages, 
chronic diarrhoea, and it is sometimes combined with cubeb in 
the treatment of gleet and gonorrhoea, as in the following pre- 
scription : 1^ Pulveris aluminis, 5j ; pulveris cubebae, §iv ; pul- 
veris cinnamomi, 5ss. M. et Sig. — Tablespoonful in half a glass 
of water 3 times a day ; an efficient mixture when it does not 
disorder the stomach. Alum is also used as an injection in 
leucorrhcea. It has also been given as an emetic in croup. Its 
use in lead-colic has been alluded to. As a topical remedy it is 
valuable as an astringent antiphlogistic in ophthalmia, diphtheria, 
and tonsillitis ; to produce contraction of the tissues, in relaxa- 
tion of the uvula, prolapsus ani, descensus uteri, cystocele or 
rectocele, and is used as a vaginal injection where the tissues 
become lax from wearing a pessary ; as a styptic in hemor- 
rhages ; and to arrest excessive secretion from the mucous sur- 
faces. In hemoptysis and bronchitis, a strong solution of alum 
may be applied by atomization. Dose, gr. x-xxx, in powder or 
solution, or made into pills with some tonic extract, and com- 
bined with an aromatic, as nutmeg, to prevent nausea. It may 
be agreeably given in the form of whey, prepared by boiling 5ij 
with milk Oj, and straining, of which the dose is f§ij. Topically, 
it is employed in the form of solution, and is useful in granular 
lids, conjunctivitis, and as an injection in gonorrhoea, attended 
with profuse discharge, gr. ij-vj to water f§ij ; in leucorrhcea, 
5j to tepid water Oj. Dried alum [alumen exsiccatuni) is employed 
internally in the dose of gr. v-x, and externally as a mild 
escharotic. 

Aluminii Sulphas (Aluminium Sulphate) (Al 2 3S0 4 .i8H 2 0) is 
employed externally as an astringent and antiseptic application 
to ulcers, and as an injection in gonorrhoea. The aqueous 
solution is used to preserve bodies for dissection. 



ORDER VI. STIMULANTS. 

Stimulants are medicines which produce a rapid and tempo- 
rary exaltation of the vital functions. Their influence is most 
conspicuous in conditions of morbid depression, when a marked 



STIMULANTS ALCOHOL. 205 

tolerance of their action is established, and large amounts are 
borne. In health, when the powers of the system are at the 
normal standard, stimulants soon induce depression. Topically, 
they irritate and inflame the parts to which they are applied, 
and hence are classed with irritants. 

Stimulants are employed principally in disorders known as 
asthenic, and in all conditions of the system attended with 
exhaustion. From their action in arousing the energies of the 
nervous system, they exercise a control over many nervous 
disorders, particularly those of a spasmodic nature. They are 
also frequently given with a view to their action on some one 
or other of the secretions. As stimulants to the gastrointes- 
tinal canal, they are administered to promote digestion (when 
they are called stomachics) and to dispel flatulence (when they 
are known as carminatives). Topically, they are employed as 
rubefacients and vesicants. 

The more powerful and rapid stimulants are called diffusible. 
In overdoses, they act as violent narcotics and sedatives. The 
diffusible stimuli usually employed are vinous and spirituous 
liquors and the preparations of ammonia. Vegetable stimulants 
which contain a volatile oil are termed aromatics, and are usually 
given as stomachics and carminatives. The volatile oils are 
also employed as local irritants. 

DIFFUSIBLE STIMULANTS. 
ALCOHOL. 

Alcohol is a product which results from a process termed 
the vinous fermentation, in substances containing grape-sugar. 
At a temperature of 8o° F., the presence of a fermenting body 
converts a solution of grape-sugar into alcohol and carbonic 
acid. Starchy substances, being convertible into grape-sugar, 
also yield alcohol. Alcohol is obtained from vinous or fer- 
mented liquors by repeated distillation. It is, chemically, an 
ethyl hydrate (C 2 H 5 HO). Officinal alcohol should be of the 
sp.gr. 0.820. It is a colorless, inflammable liquid, wholly vapor- 
izable by heat, and unites in all proportions with water and ether. 
Contamination of fusel oil or amylic alcohol may be detected by 
agitation with concentrated sulphuric acid, when, if the alcohol 
become colored, the presence of the impurity is indicated in 



206 MATERIA MEDICA NEUROTICS. 

proportion to the depth of the color; or solution of silver nitrate, 
with exposure to a bright light, will convert fusel oil into a black 
powder. 

Pliysiological Effects. — Alcohol * is the intoxicating ingredient 
of all vinous and spirituous liquors"}". Locally, alcohol acts as an 
astringent by hardening the albumen and condensing the tissues. 
It evaporates rapidly, causing a feeling of coolness. When eva- 
poration is prevented, it acts as an irritant (due to absorption and 
paralysis of the cutaneous vessels), and may even produce inflam- 
mation. When inhaled it may produce anaesthesia, stupor and 
death. Nervous system : when taken internally, in small doses, 
it stimulates the cerebral hemispheres, possibly by the hypere- 
mia induced ; in large doses it causes excitement with impaired 
coordination of ideas ; and in excessive doses it produces coma. 
Small doses stimulate the spinal cord, while larger amounts 
weaken the centres governing automatic motion and coordination, 
and lessen the sensibility of the cutaneous nerves, especially that 
of the fifth pair of cranial nerves. Large doses paralyze the vaso- 
motor nerves, giving rise to dilatation of the arterioles, flushing 
of the surface, and sensations of heat. In inflammatory diseases, 
medicinal doses contract the arterioles by giving tone to the vaso- 
motor system, and prevent the migration of white corpuscles 
(Farquharson). In toxic doses, the nervous centres are involved 
in the following order: I. The gray matter of the convolutions 
and the higher functions of animal life (shown by disordered 
intellection). 2. The basic ganglia (shown by disordered sen- 
sation and motion). 3. The cerebellum (shown by disordered 
equilibration. This may be in part due to impairment of the 
muscular sense). 4. The spinal centres (shown by anaesthesia of 
the lower limbs, extending to the upper limbs and body, diffi- 
culty in performing automatic acts, impaired coordination, etc.). 
5. The medulla oblongata (shown by labored breathing, and 
finally death from apncea). Circulation : alcohol at first stimu- 
lates, but afterward depresses, the cardiac motor ganglia. In 

* Alcohol considered chemically, physiologically, medicinally and as a cause of 
disease. Essay awarded the Henry C. Lea Prize, Jefferson Medical College, March, 
1878, by Henry Morris, M. D. 

I According to Dujardin-Beaumetz the toxic effects of the alcohols increase with 
the sum of their atomic weights, with the exception of the highest and lowest. 



STIMULANTS ALCOHOL. 207 

small doses it increases the frequency of the cardiac beat, -with- 
out affecting the force or rhythm, increasing the rapidity of the 
contraction and shortening the diastole (Parkes and Wollowicz), 
and also elevating the arterial tension. This is soon followed by 
slowing of the heart and lowered arterial tension, and if the dose 
has been larger, by weak and irregular contraction. Large doses 
depress and paralyze the cardiac muscle. Respiration is at first 
quickened, but afterward slowed. In alcohol-narcosis the breath- 
ing is very slow, and death may result from apncea. Tempera- 
ture: small doses slightly elevate the temperature. If large 
amounts have been taken, the temperature is depressed, owing 
to the radiation of heat from the dilated cutaneous vessels, to 
lessened oxidation of tissue, and, in alcohol-narcosis, or in the 
case of animals, to muscular inactivity. The power of resisting 
cold is lessened by the habitual ingestion of alcohol. Secretion : 
the secretions are at first increased, then diminished. Alcohol 
diminishes the quantity of urea, uric acid, sodium chloride, 
phosphoric and sulphuric acids excreted in the urine. Sugar is 
sometimes found in the urine after the ingestion of alcohol. Small 
doses stimulate the liver, while larger amounts alter the quality 
of the bile, which may be profuse or scanty. The amount of 
carbonic acid exhaled from the lungs is diminished. Stomach: 
small doses increase the flow of gastric juice, by producing 
hyperemia, and thus stimulate the appetite and digestion. Large 
doses check the gastric secretion, precipitate the pepsin, and 
cause anorexia and nausea. When taken habitually, it produces 
a slow interstitial inflammation of the mucous membrane with 
hyperplasia of the connective tissue elements, which, contracting, 
compress the gastric glands. The secretion will then be much 
diminished, and the mucous membrane covered with a ropy, 
glairy mucus. Blood : alcohol must be in a certain state of 
dilution before it can be absorbed. It is said to precipitate the 
albumen in the blood, but it must be in too diluted a condition 
to accomplish this, nor are the consequences of an occasional 
indulgence sufficiently serious to warrant this statement. It 
diminishes the power of the red corpuscles to carry oxygen, and 
changes the blood by its effect on the liver and digestion. Fat 
in the blood of drunkards is increased from 8.65 parts to 11.7 
parts per 1000 (Lecann). Scharlau found 30 per cent, more 



208 MATERIA MEDICA NEUROTICS. 

carbon in the blood of drunkards than in that of healthy persons. 
This is due to the avidity with which alcohol combines with 
oxygen, preventing the oxidation of the hydrocarbons. Mus- 
cular system : the muscular power is weakened and the muscular 
sense diminished. Elimination : alcohol is eliminated unchanged 
in small proportion to the quantity ingested by the kidneys, 
lungs, and to a slight extent by the skin, and probably by the 
liver, traces having been detected in the bile by Dr. Percy. A 
portion of the alcohol (about ff>iij) disappears in the system, 
being probably oxidized, for Anstie,* in a series of elaborate 
experiments on dogs, was able to recover only about one-fourth 
of the amount administered. The economy seems to be able to 
consume this quantity daily, storing it up as potential energy, 
anything above this being carried away under another form by 
the eliminating organs. Though fgiij may disappear in the sys- 
tem, yet it is not to be considered as contributing at all to the 
normal support of the body. Experience gained in Arctic voyages 
proved that alcohol was totally unnecessary as an article of diet, 
and that tea as a restorative stimulant was a much better sub- 
stitute. The symptoms of acute and of chronic poisoning by 
alcohol are too well known to need description. The treatment 
in cases of poisoning from alcohol is the same as that which is . 
to be pursued in cases of poisoning from opium, except the use 
of atropia and flagellation. Ammonia is a physiological anti- 
dote, and later the exhibition of strychnia does good. Mania-a- 
potu is found in acute poisoning from alcohol, and is due to the 
direct action of alcohol on a brain rather unaccustomed to- its 
effects. It differs from delirium tremens, which is a delirium of 
a trembling type found in chronic alcoholism. The habitual use 
of alcoholic narcotics in excess gives rise to a well-known train 
of mental and physical disorders ; viz., dyspepsia, visceral ob- 
structions, cirrhosis of the liver, gout, organic disease of the 
heart, delirium tremens, paralysis, and even confirmed insanity. 

Medicinal Uses. — Alcohol, in the form of vinous and spirituous 
liquors, is employed to rouse and support the system in debility, 
asphyxia, syncope, the latter stages of acute attacks, typhoid 
and typhus fevers, asthenic and malignant diseases, exhausting 

* The Practitioner, Vol. Ill, p. 15. 



STIMULANTS ALCOHOL. 200, 

hemorrhages and suppurations, gangrene, to counteract the effects 
of the bites of venomous reptiles, in delirium tremens, and in 
poisoning from digitalis, tobacco, and other narcotics ; also as a 
stomachic in colic, flatulence, indigestion, nausea, etc. In typhoid 
and typhus fevers, alcohol probably acts as a physiological antidote 
to the blood poison, and should be given in the very first stages 
of the fevers, regulating the size and frequency of the dose by the 
sounds of the heart and the character of the pulse. Rarely more 
than fSyj-viij are required daily. As a stimulant in diphtheria its 
administration is of the greatest service in counteracting the 
depressing effects of the poison, and in the treatment of acute 
lobar pneumonia, to prevent heart-insufficiency it is our most 
efficient remedy, the indications for its administration being 
the same as in typhoid fever. Indeed, the early administration 
of the preparations containing alcohol furnishes our best means 
of counteracting the depressing action of disease in general. 
The true stimulant or supporting effects of alcohol probably 
depend upon its appropriation by the system through oxidation 
or other agency. In disease, large quantities are administered 
which cannot be recovered in the execretions. But in health, 
when the powers of the economy are at the normal standard, 
it probably circulates in the blood unchanged, and accumulates 
in the viscera or is eliminated by the secretions. In wakefulness 
due to cerebral anaemia, a little alcohol at bedtime will often 
produce refreshing sleep. Alcohol, when prescribed to build up 
the system, should be given after food, in order to hinder it from 
diffusing too rapidly into the blood. The hypodermic injection 
of a syringeful of brandy or whiskey, repeated if necessary, is 
an efficient restorative in collapse, and in asthenic conditions 
generally, especially where dissolution appears to be eminent. 
As a topical application, alcohol is used to produce cold by its 
evaporation ; as a styptic ; to harden the cuticle over delicate 
parts ; and as a stimulant. Mixed with white of eggs, it forms a 
good coating to bed-sores. 

Alcohol Dilutum {Diluted Alcohol), or Proof Spirit, consists 
of equal parts of alcohol and distilled water, and has a sp. gr. 
O.928. It is used exclusively for pharmaceutical purposes. 

Vinum (Wine). The fermented juice of the grape consists of 
water and alcohol in varying proportions with fixed and volatile 
14 



2IO MATERIA MEDICA — NEUROTICS. 

acids, sugar, cenanthic acid and ether, tannic, malic and other acids, 
potassium bitartrate, etc. Wine loses most of its cream of tartar 
by age. It is employed medicinally in typhus and typhoid fevers, 
exhausting chronic diseases, extensive suppurations, gangrene, 
etc. In typh-fevers it constitutes our chief therapeutic resource, 
and may be administered to the amount of one or two pints in 
the twenty-four hours, either pure or in the form of wine-whey. 
This is made by adding from a gill to half a pint of white wine 
to a pint of boiling milk, separating the curd from the whey, 
and flavoring with sugar and spices. 

The officinal wines are Vinum Album {White Wine), contain- 
ing between 10 and 12 per cent, of absolute alcohol by weight; 
Vinum Album Fortius {Stronger White Wine), containing be- 
tween 20 and 25 per cent, of absolute alcohol ; and Vinum Ru- 
brum (Red Wine), containing between 10 and 12 percent, of abso- 
lute alcohol. Red wines are more astringent than white, as they 
contain more tannic acid. Port wine contains tannic acid, and is 
used in dysentery and diarrhoea, for its astringency. Madeira, 
which is the strongest of the white wines, is an excellent stimu- 
lant, but may be objectionable from its acidity. CJiampagne is a 
pleasant stimulant where gastric irritability is present. Madeira 
and port contain about 23 per cent, of alcohol ; sherry, 19 per 
cent.; champagne, 13 per cent. As articles of diet, the stronger 
wines, when used in excess, often produce gout, and diseases 
of the kidneys and liver ; and except in advanced age and in 
feeble constitutions, or where the tuberculous diathesis exists, 
cannot but be considered as objectionable. 

Spiritus Vini Gallici {Brandy) is obtained by the distillation 
of wine. It contains about 50 per cent, of alcohol, with water, 
volatile oil, tannic acid, coloring matter, etc. It is the best stimulus 
where a rapid and decided impression is called for, as in collapse 
and syncope ; and, from the tannic acid which it contains, is use- 
ful in bowel complaints. Spiritus Frumenti ( Whiskey), obtained 
from fermented grain by distillation, is of about the same alco- 
holic strength as brandy, and may be substituted for it ; it does 
not contain tannic acid. Rum (Spiritus Sacchari), the ardent 
spirit obtained from sugar, is more sudorific than brandy. Gin 
(Spiritus Juniperi) is corn-spirit flavored with oil of juniper ; and 
owing to the oil of juniper which it holds in solution, it is an 



STIMULANTS PREPARATIONS OF AMMONIA. 211 

active diuretic as well as stimulant and stomachic. Arrack, the 
spirit of Eastern countries, is prepared from a fermented infusion 
of rice. Spiritus Myrci^e {Spirit of Myrcia), bay-nun, the spirit 
obtained by distilling rum with the leaves of myrcia acris, is a 
refreshing local application. 

The malt liquors are useful where permanent stimuli are 
called for, as in diseases tending to emaciation, chronic abscesses, 
etc. In wakefulness caused by cerebral anaemia, a glass of ale 
or beer, at bedtime, is an efficient hypnotic. They are contra- 
indicated in all chronic liver and renal affections and in disorders 
of the alimentary canal accompanied with acidity and flatulence, 
especially in those disorders depending on fermentation of food. 
Although they contain a much smaller proportion of alcohol (2 
to 6 or 8 per cent.) than the wines, yet their habitual ingestion 
will inevitably cause fatty degeneration of the liver and heart, 
already alluded to. Besides alcohol they contain extract of malt, 
and are, therefore, to some extent, nutritive. The best are porter 
and ale. 

Extractum Malti (Extract of Malt) is officinal. It is made 
by macerating and then digesting coarsely-powdered malt (the 
seed of Hordeum distichum, or barley (Nat. Ord. Graminacese) 
caused to enter the incipient stage of germination by artificial 
means and dried) with water, straining and evaporating the fluid 
thus obtained to the consistence of a thick honey. It has a 
yellowish-brown color and the sweet taste of malt. It contains 
some dextrine, sugar, bitter and aromatic substances, and is used as 
a tonic in debility and nervous exhaustion. It possesses few 
advantages over good malt liquors. It is used as a vehicle for 
cod-liver oil. It aids the digestion of starch by promoting its 
conversion into dextrine and glucose. It may be given in doses 
of f5j-iv after meals. 

AMMONITE PR^PARATA— PREPARATIONS OF AMMONIA. 

Ammonia (sometimes termed volatile alkali) is a gaseous com- 
pound of hydrogen and nitrogen (NH 3 ), which is found abun- 
dantly as the result of the decay of organic substances, and is 
usually obtained by the action of lime on sal ammoniac (or am- 
monium chloride). It has a pungent odor, and is very soluble 



212 MATERIA MEDICA NEUROTICS. 

in water ; it is a powerful stimulant and local irritant, but is 
rarely used in medicine. 

Physiological Effects. — Locally, ammonia in solution acts as an 
irritant, causing vesication, and, after prolonged contact, slough- 
ing of the surface. When inhaled it produces inflammation of 
the laryngeal and bronchial mucous membranes, and may cause 
pneumonia. Internally — Nervous system ; when injected into 
the veins of animals it causes convulsions, due to stimulation of 
the motor centres of the spinal cord and of its reflex functions. 
Circulation : after intravenous injections, a momentary fall in the 
arterial pressure takes place, followed by a decided and sudden 
rise (not due to any action on the vaso-motor nerves, as it occurs 
after section of the cord), and a corresponding increase in the 
rapidity of the pulse from stimulation of the accelerators of the 
heart. Blood: it prevents coagulation of the blood, assists in 
retaining the fibrogenous materials in solution, and impairs the 
function of the red corpuscles as oxygen-carriers. Respiration : 
when injected into the veins the respiratory act is greatly acceler- 
ated. Elimination : it is probably, to a great extent, oxidized in 
the system, and is eliminated as nitric acid, and perhaps as urea, 
by the kidneys. The effects just described are produced also by 
the following preparations of ammonia, which are employed as 
diffusible stimuli : — 

Aqua Ammonite Fortior {Stronger Ammonia-Water). This 
is an aqueous solution of ammonia of the specific gravity 0.900. 
It is a colorless liquid, wholly volatilizable by heat, of a caustic, 
acrid taste and has a very pungent odor of ammonia ; and is too 
strong for medicinal use internally in its unmixed state, con- 
taining 28 per cent., by weight, of gaseous ammonia. It is a 
powerful corrosive poison, for which the diluted acids, as vine- 
gar or lemon juice, are the antidotes. In the case of a man* 
who swallowed foj of it, death followed suddenly, his breathing 
being obstructed, and the lips, tongue, uvula and tonsils much 
swollen, reddened and glazed. It is used externally as a vesicant, 
and has the advantage over cantharides of a more speedy opera- 
tion and non-affection of the urinary organs, but is a very 
painful application. 

* Guy's Hosp. Reports, XVII, 3d ser., p. 225. 



STIMULANTS PREPARATIONS OF AMMONIA. 21 3 

Aqua Ammonite {Ammonia-Water) has a specific gravity of 
0.959, containing 10 per cent, by weight, of ammonia, and is 
employed as a stimulant, antacid and rubefacient. As a stimulant, 
ammonia is admirably adapted for speedily rousing the action 
of the vascular and respiratory systems, especially when it is an 
object at the same time to promote the action of the skin. For 
this purpose it is employed in low forms of disease, particularly 
in the typhoid exanthemata, in syncope, in asphyxia from nar- 
cotic poisons, and to counteract the effects of the bites of venom- 
ous reptiles. In dyspepsia it is useful with a view to the relief 
of both acidity and flatulence. For internal use other prepara- 
tions of ammonia are generally preferred, and this is used chiefly 
as a rubefacient. Dose, internally, gtt. x-xxx, largely diluted. 
As a rubefacient the officinal liniment {q. v) may be used. 

Spiritus Ammonle {Spirit of Ammonia) is a solution of ammo- 
nia in alcohol, containing 10 per cent, of the gas. It is given as 
a stimulant, antacid and carminative, in the dose of gtt. x-xxx, 
diluted with water. But a pleasanter preparation, with similar 
properties, is — 

Spiritus Ammonia Aromaticus {Aromatic Spirit of Ammonia). 
This is a solution of ammonium carbonate and water of ammonia, 
oil of lemon, oil of pimenta, and oil of lavender flowers, in water 
and alcohol. It is a very agreeable antacid, stomachic and stimu- 
lant, and may be given in the dose of gtt. xxx to f 5j, or more, 
diluted with water. 

Ammonii Carbonas {Ammonium Carbonate) (NH 4 HC0 3 .NH 4 - 
NH 2 C0 2 ), being analogous in its effects to those of the prepa- 
rations of ammonia, is considered here. It is prepared by 
subliming a mixture of ammonium chloride and chalk, and 
consists of a mixture * either of one or two molecules of acid 
ammonium carbonate and one molecule of ammonium carbamate. 
It occurs in whitish, transparent masses, wholly dissipated by 
heat, of a pungent, ammoniacal odor, an acrid, alkaline taste, and 
is soluble without residue in water. On exposure to air it 
becomes opaque, falls into powder, and deteriorates by the loss 
of ammonia. 

* "U. S. Dispensatory," 1888, p. 172. 



214 MATERIA MEDICA NEUROTICS. 

Effects and Uses. — Its indications are the same as those of 
solution of ammonia, to which it is preferred for internal exhibi- 
tion as a diffusible stimulant, It is especially valuable in pneu- 
monia, and by some therapeutists is relied on to the exclusion of 
other medication in this disease. By others it is here regarded 
serviceable only as a stimulant ranking after alcohol, and without 
influence to prevent heart-clot (Loomis). The truth seems to be 
that it is adapted only to cases which can be antagonized by its 
proved physiological action. It is a useful adjunct to other 
remedies in the treatment of capillary bronchitis; and in chronic 
bronchitis with profuse expectoration, diminished strength and 
impeded cardiac action, its exhibition, gr. v, every hour or so, is 
indicated. It has been recommended in threatened thrombosis, 
as in the puerperal state. Dose, gr. v-x, in pill or preferable in 
solution with gum and sugar. The fluid extract of glycyrrhiza 
somewhat disguises its unpleasant taste. Mixed with some aro- 
matic oil (as that of bergamot or lavender), it is used as a smelling 
salt in syncope and hysteria. 

AROMATICS. 

Aromatics owe their virtues to the presence of oils obtained 
from them by distillation, and termed volatile oils (plea volatilia), 
sometimes also distilled and essential oils. These oils possess, in 
a high degree, the odor and taste of the plants from which they 
are procured. Locally, they are powerful irritants, and, when taken 
into the stomach in overdoses, act as acrid poisons. They pass 
partially into vapor at ordinary temperatures, and are completely 
volatilized by heat ; hence, decoctions and extracts are improper 
preparations of the aromatics. The distilled oils are inflammable, 
very slightly soluble in water, but soluble in alcohol and ether. 
Their ultimate constituents are, usually, carbon, hydrogen, and 
oxygen ; and on exposure to the air they gradually absorb oxy- 
gen, become thicker, less odorous, and of a deeper color, and are 
finally converted into resins. The effects and uses of most of the 
members of this group are similar. In medicinal doses they are 
used as carminatives, and are combined with purgatives to prevent 
griping. Most of them are also useful as flavoring ingredients. 
To many of the volatile oils emmenagogue virtues have been 
ascribed ; but these effects are only produced by poisonous doses. 



STIMULANTS CAPSICUM. 2 I 5 

Locally, they are used as rubefacients, antiseptics and to allay 
neuralgic pains. 

CAPSICUM. 

Capsicum or Cayenne pepper is the fruit of Capsicum fas- 
tigiatum and other species of Capsicum {Nat. Ord. Solanaceae), 
American tropical plants, naturalized in most warm climates, and 
cultivated in our gardens. C. fastigiatum is a small shrub, with 
a crooked, branching stem, producing in each fork two or three 
fruits from one-half to three-quarters of an inch long, of a sub- 
conical form and crimson or yellow color. These pods, when 
dried and ground, form capsicum, the best of which is the African. 
Powdered capsicum has a bright-red color, which fades upon 
exposure to light, an aromatic, peculiar smell, and a bitterish, 
acrid, burning taste. A principle termed capsaicin * (probably a 
mixed substance), slightly soluble in water, but very much so in 
alcohol and ether, exists in capsicum, associated with resin and 
fixed and volatile oil. 

Effects and Uses. — Locally, capsicum acts as an irritant, and 
vesication may be produced by prolonged contact with the skin. 
Lntemally. — Circulation : it increases the action of the heart. 
Secretion : it stimulates the glands with which it comes in con- 
tact, and increases the flow of the saliva and the gastric and 
intestinal juices. Elimination : it passes out of the system by the 
kidneys, increasing the flow of urine, and sometimes producing 
vesical tenesmus and aphrodisiac effects. In large doses it acts 
as a gastro-intestinal irritant. Contra-indications : capsicum 
should not be given in acute inflammatory affections of the stom- 
ach, intestines or genito-urinary apparatus. Capsicum is princi- 
pally employed as a condiment and stomachic, and is very useful 
in torpid conditions of the digestive organs, or as an adjunct to 
other remedies to rouse the susceptibility of the stomach. Its 
constitutional effect is not in proportion to its local effect, and it is, 
therefore, of no great efficiency as a diffusible stimulant. It is a 
good stomachic in the dyspepsia of drunkards. It is employed 
as a gargle, and also as a cataplasm to cause counter-irritation. 
Dose, of the powder, gr. v-x, in pill ; of the tincture (5 parts to 



* Fliickiger, " Pharmacographia," 2d ed., p. 454, isolated also a volatile alkaloid 
having the smell of conium, from the seeds and pericarp of capsicum. 



2l6 MATERIA MEDICA — NEUROTICS. 

diluted alcohol 95 parts), i^x-f5j ; of the fluid extract, f^v-x. The 
oleo-resin is a powerful rubefacient, and may be given internally 
in the dose of gr. ss-j. A plaster is also officinal. 

piper — PEPPER. 

Black pepper is the unripe fruit of Piper nigrum (Nat. Ord. 
Piperaceae), a vine of the East Indies. The berries are gathered 
before they are quite ripe, and dried in the sun. They are 
wrinkled and black, in consequence of the drying of the pulp 
over the grayish-white seed, and in this state are known as black 
pepper. If permitted to ripen, and soaked in water till the outer 
coat is removed, they constitute white pepper. Pepper has an 
aromatic, peculiar odor and a hot, spicy, pungent taste. Its pro- 
perties are taken up by alcohol and ether, and partially by water. 
It contains a volatile oil, an acrid resin, an alkaloid called piperine 
(C 17 H 19 N0 3 ), which is used as an anti-periodic remedy. Dr. C. S. 
Taylor reports success w T ith it where quinine failed, or the idio- 
syncrasy of the patient would not permit its employment. In 
warm-blooded animals it reduces the number of respirations, 
increases the frequency of the cardiac beats (apparently from 
paralysis of the vagus centre), dilates the pupils widely, and 
arrests the heart in systole. 

Effects and Uses. — The effects of pepper are similar to those of 
capsicum. It is a warm carminative stimulant, chiefly employed 
as a condiment, but it is also a useful stomachic. Dose, gr. v-xx- 
Of the oleo-resin the dose is gr. ss-ij. Piperina {piperine} may be 
prescribed in doses of gr. ij-iv. 

cinnamomum — cinnamon. 
There are two varieties of cinnamon — Ceylon cinnamon, which 
is the inner bark of the shoots of Cinnamomum zeylanicum, a 
tree of Ceylon and Java; and China cinnamon, or cassia, the 
bark of the shoots of one or more undetermined species of Cin- 
namomum {Nat. Ord. Lauraceae), trees of China. The most 
esteemed is the Ceylon cinnamon. It is found in the shops in 
long, cylindrical pieces, which are very thin and smooth, and of 
a yellow-brown color and a splintery fracture. It has a fragrant 
odor and a warm, sweetish, aromatic, slightly astringent taste. 
Its constituents are volatile oil, tannic acid, mucilage, sugar, mannit, 



STIMULANTS — MACE. 2\J 

etc. The greater part, however, of the cinnamon brought bo this 
country is the cassia cinnamon. It has the general appearance, 
smell and taste of true cinnamon, but the pieces are not doubly 
quilled. Its properties are identical with those of the Ceylon 
variety. 

Effects and Uses. — Cinnamon is an aromatic stimulant, with a 
slight astringency. It is used chiefly as a carminative, and as an 
addition to other medicines. Dose, gr. x-xxx; of the tincture 
( 10 parts, alcohol and water enough to make 1 00 parts of tinc- 
ture), the dose is f5j-iij. Oleum cinnamomi {oil of cinnamon) is of 
a light-yellow color, which deepens by exposure to the air, with 
the development of an acid, termed cinnamic ; dose, gtt. i-ij. 
Aqua cmnamomi {cinnamon-water) is used as a vehicle for other 
medicines. Spiritus cinnamomi {spirit of cinnamon) contains 10 
parts of the oil dissolved in 90 parts of alcohol ; dose, gtt. x-xx. 
Cinnamon enters into a large number of preparations. 

M YRISTICA— NUTM EG. 
MACIS MACE. 

The products are portions of the fruit of Myristica fragrans 
{Nat. Ord. Myristicaceae), a tree of the Moluccas, cultivated also 
in Java and Sumatra and other parts of the East Indies, and 
introduced into the isles of France and Bourbon and several of 
the West India islands. It bears a pyriform fruit about the size 
of a small peach, which has a fleshy pericarp, opened by two 
longitudinal valves. Within this is the arillus, a scarlet reticu- 
lated membrane, which, when dry, becomes yellow-brown and 
brittle, and is termed mace. The kernels of the seed are the 
nutmegs. They are oval, of the size of an olive, of a grayish- 
brown color, marked with furrows ; and to preserve them from 
the attacks of an insect, they are steeped in a mixture of lime 
and water. Mace has a pleasant, aromatic smell and a warm, 
bitterish, pungent taste. Nutmegs have a delightfully fragrant 
odor and a warm, aromatic, grateful taste. Nutmeg contains 
a volatile oil (consisting of myristicene, Ci H 16 , and a little myris- 
ticoll, C 10 H 14 O), fixed oil {2^ per cent.), starch, proteids, etc. From 
mace, also, a volatile oil, etc., is obtained. 

Effects and Uses. — Nutmeg is one of the most agreeable of the 
aromatic stimidants, and is muck employed for its carminative 



218 MATERIA MEDICA NEUROTICS. 

virtues, also as a flavoring ingredient, and to obviate the griping 
effects of cathartics. It possesses narcotic properties. Mace is 
chiefly employed as a condiment. Dose of either, gr. xx-xxx. 
Oleum myristicce (oil of nutmeg) is of a pale straw color; dose, 
gtt. ij-iij. Spiritus myristiccE is made by dissolving 3 parts of the 
oil in 97 parts of alcohol; dose, f5j-ij. 

CARYOPHYLLUS CLOVES. 

Cloves are the unexpanded flowers of Eugenia caryophyl- 
lata (Nat. Ord. Myrtacese), an evergreen tree of the Moluccas. 
They are from five to ten lines long and from one line to one 
line and a half thick, the corolla forming a ball or sphere at the 
top, and the calyx a tapering, somewhat quadrangular base, 
resembling a nail, whence the common name, from the French 
clou. When good, they are of a dark-brown color, with a 
yellowish-red tint ; they have a strong, fragrant odor, a hot, 
acrid taste, and when pressed with the nail, should give out oil. 
They contain a highly pungent volatile oil, tannic acid, resin, etc., 
and two crystalline principles, termed caryophillin and eugenin ; 
the oil consists of a hydrocarbon (C 10 H 16 ) and a colorless oil 
termed eugenol or eugenic (QoH^C^). 

Effects and Uses. — Cloves are among the most stimulating of 
the aromatics, but are used chiefly as a flavoring ingredient and 
as a condiment. Dose, gr. v-x. The oil, oleum caryopliylli, is pale 
or yellowish, becoming darker by age ; dose, gtt. iij-vj. 

PIMENTA. 

Pimenta, called also Allspice, is the unripe berries of Eugenia 
Pimenta (Nat. Ord. Myrtaceae), a handsome evergreen tree of the 
West Indies and South America. It comes exclusively from 
Jamaica, and consists of round, brown, roughish berries, rather 
larger than black peppercorns, with an external hard, brittle 
shell, inclosing two dark- brown seeds. They have an aromatic, 
agreeable smell and a strong clove-like taste. They are princi- 
pally used as a condiment. The oil, oleum pimentce, has a brown- 
ish-red color, and consists of a hydrocarbon and eugenic acid ; 
dose, gtt iij-vj. 

Oleum Cajuputi (Oil of Cajeput). The volatile oil distilled 
from the leaves of Melaleuca cajuputi (Nat. Ord. Myrtaceae), a 



STIMULANTS — CARDAMOM. 2 I O, 

tree of the Moluccas, is a powerful diffusible aromatic stimu- 
lant, much employed in Eastern countries, and of late coming 
into use in the United States. It is a transparent oil, of a fine 
green color, a lively, penetrating odor analogous to that of 
camphor and cardamom, and a warm, pungent taste. It is an 
admirable remedy for the relief of nausea and intestinal pain, 
and is added as a carminative to purgative pills to prevent grip- 
ing ; dose, gtt. j-v. 

ZINGIBER GINGER. 

Ginger is the rhizome of Zingiber officinale (Nat. Ord. Taxy- 
giberaceae), a perennial herbaceous plant, growing to the height 
of two or three feet. Its native country is Asia, where it has 
been cultivated from time immemorial, and was early introduced 
into the tropical regions of America. Ginger-root occurs in 
flattish, jointed, branched or lobed pieces, which rarely exceed 
four inches in length. In the young state, the roots are pre- 
served in sugar, and form a very pleasant sweetmeat. When 
old, they are taken up, scalded in hot water, and dried, when 
they are known as black ginger. Sometimes they are scraped 
previously to being dried, and are then called white ox Jamaica 
ginger. Both varieties have a powerful odor and a warm, pun- 
gent, aromatic taste. They impart their virtues to water and 
alcohol, and contain a pale-yellow volatile oil, gingerol (to which 
the hot taste is due), resin, starch, etc. 

Effects and Uses. — Ginger is a pungent, aromatic stimulant, 
much employed as a stomachic in flatulency, and spasm of the 
stomach and bowels. It is used also as a condiment, and to 
correct the unpleasant taste and nauseating qualities of other 
medicines. A paste made of the powder and warm water is 
used as a counter-irritant. Dose, gr. x-xx, in pill. The officinal 
preparations are : tincture — dose, f5ss-j ; fluid extract — dose, gtt. 
xx-xxx ; syrup — used as a vehicle for other medicines ; oleo-resin 
— dose, gtt. j-ij ; and troches (made by mixing the tincture with 
tragacanth, sugar, and a little syrup of ginger). 

cardamomum — cardamom. 
Cardamom is the fruit of Elettaria Cardamomum (Nat. Ord. 
Zingiberaceae), a perennial plant, from six to nine feet high, 
found in the mountainous parts of Malabar. Three varieties 



220 MATERIA MEDICA NEUROTICS. 

of Malabar cardamoms are known in commerce : shorts, short- 
longs, and long-longs, all furnished by the same plant. They 
are ovate-oblong, from three to ten lines long, coriaceous, 
ribbed, and of a grayish or brownish-yellow color, and contain 
a number of blackish or reddish-brown seeds, which have a 
pleasant, aromatic odor and a warm, aromatic, agreeable taste. 
They yield a colorless volatile oil, a fixed oil, starch, etc. 

Effects and Uses. — Cardamom is a very agreeable aromatic, 
devoid of acridity, and is employed as a stomachic and carmina- 
tive, and as an adjuvant and corrective of other medicines ; dose, 
gr. v-x. The tincture (15 parts to diluted alcohol 85 parts) is 
the preparation chiefly used ; dose, f5j-ij. The compound tincture 
contains cardamom, and also caraway, cinnamon, cochineal, 
diluted alcohol, and glycerin. 

Pulvis Aromaticus {Aromatic Powder) consists of cinnamon 
and ginger, each 35 parts, cardamom and nutmeg, each 15 parts. 
It is used as a carminative in doses of gr. x to xxx. 

Extractum Aromaticum Fluidum {Aromatic Fluid Extract) is 
a fluid extract of aromatic powder. It is chiefly used as a flavor- 
ing ingredient in mixtures, but may be used where aromatic 
powder is indicated in doses of f5ss-j or more. 

CALAMUS. 

The rhizome of Acorus calamus or Sweet Flag {Nat. Ord. 
Araceae), an indigenous marshy plant, with long, sword-shaped, 
radical leaves (giving out a delicious fragrance when rubbed), is 
a valuable aromatic stimulant, with some tonic properties. It is 
found in the shops in somewhat flattened pieces, deprived of their 
epidermis, wrinkled, and of a yellowish color, and has a strong, 
fragrant odor and a warm, bitterish, aromatic taste. It contains 
volatile oil, acorin (probably a glucoside), resin, starch, etc. Dose, 
gr. xx to 5j- A fluid extract is officinal; or it may be given in 
infusion. 

GAULTHERIA. 

Gaultheria procumbens, Partridge-berry, Deer-berry, or Tea- 
berry {Nat. Ord. Ericaceae), is a small indigenous evergreen plant, 
with reddish stems, a few inches in height, bright-green leaves, 
and white, ovate, five-toothed flowers, followed by scarlet berries. 



STIMULANTS GAULTHERIA. 



221 



The leaves are the officinal portion, and contain a very stimu- 
lant volatile oil (oleum gaultherice), which, when first distilled, is 
colorless, but gradually becomes reddish, and is distinguished as 
being the heaviest of the volatile oils. It consists of gaultheri- 



Fig. 15. 




ACORUS CALAMUS. RHIZOME. 



lene (C 10 H ]6 ), and methyl salicylate (CH 3 .C 7 H 5 3 ). The leaves 
also contain arbutin, ericolin, urson, tannin, sugar, etc. The offici 
nal preparations are the oil and the spitit (containing 3 parts of 



222 



MATERIA MEDICA NEUROTICS. 



the oil in ioo of the preparation.) An infusion of the leaves is 
in very general popular use as a carminative and stomachic. 

The oil of gaultheria has been used with considerable success 
in acute rheumatism. Dr. Kinnicutt* reports twelve cases treated 
by it with the following results : complete absence of pain in 
about three days; duration of fever, 3^ days ; average stay in 
hospital, 24^ days. Gottheilf finds that it reduces the local 
swelling and relieves the pain (four cases) ; while A. Flint, Sr.,J 
states that the average length of confinement to hospital was, in 
eleven cases, less than five days — a very favorable showing. 
All of these observers gave it in frequently repeated doses 
(gtt. x), Flint, in flaxseed tea. 



Fig. 16. 




GAULTHERIA PROCUMBENS. LEAVES. 



Dr. Pinkham § reports four cases of poisoning by oil of gaul- 
theria, in which f 5ss was the fatal dose in each. In all severe 
symptoms of irritation of the gastro-intestinal tract and disturb- 
ance of the cerebral functions were noted. It seems to be a 
narcotico-irritant poison. 



*N. Y. Med. Record, 1882, p. 505. ^Ibidem, 1883, p. 256. %Ibidem, 1883, p. 725- 
\ Boston Med. and Surg. Journ., Dec. 8th, 1887. 



STIMULANTS SWEET ORANGE-PEEL. 223 

AURANTII AMARI CORTEX BITTER ORANGE-PEEL. ,, 

AURANTII DULCIS CORTEX SWEET ORANGE-PEEL. 

The rind of the fruit of Citrus vulgaris, or Bitter Orange, 
and Citrus aurantium, or Sweet Orange [Nat. Ord. Aurantiaceae), 
is much employed as a flavoring addition to other medicines. 
They contain volatile oils, hesperidin (a bitter crystalline gluco- 
side), etc. The flowers (aurantii flores) yield a delightful vola- 
tile oil termed oil of neroli (officinal). The following are the 
officinal preparations : orange-flower water (aqua aurantii florum), 
an agreeable vehicle, possessing slight antispasmodic virtues; 
syrup of orange-flowers and syrup of orange are used as excipients 
and vehicles for medicines of unpleasant flavor : oil of orange- 
peel ; fluid extract of bitter orange-peel ; spirit of orange ; elixir of 
orange-peel. The tincture of bitter orange-peel and tincture of 
sweet orange-peel may be given in doses of f 5j-ij. 

The following aromatics, of the natural order Labiate, are 
pleasant carminatives and stomachics : — 

Lavandula (Lavender). The flowers of Lavandula vera, a 
small European shrub, cultivated in our gardens, about two feet 
high, with fragrant blue flowers, which are gathered in June, 
and dried in the shade. They have an agreeable, fragrant odor 
and a pungent, bitter taste They contain volatile oil, resin, a 
little tannin, etc. The oil (oleum lavandula? florum), which is of a 
pale-yellow color, or the oil of lavender (oleum lavandidce — a vola- 
tile oil distilled from the whole herb), may be used in the dose 
of from gtt. j-v. But the preferred preparations are the spirit 
(spiritus lavanduloi) and the compound tincture (tinctura lavaiidulce 
compositd), which contains also oil of rosemary, cinnamon, cloves, 
nutmeg, and red saunders ; dose, f5j. 

Mentha Piperita (Peppermint) and Mentha Viridis (Spear- 
mint) are European plants, naturalized in the United States. 
The leaves and tops are employed ; they have an aromatic 
odor and a pungent, somewhat bitter taste, followed by a sensa- 
tion of coolness. Mentha viridis contains a volatile oil, gum, 
resin, etc.; Mentha piperita a volatile oil (consisting of Ci H ]8 O 
and a crystallizable substance termed menthol, C 10 H2oO), a little 
tannin, resin, etc. 



224 MATERIA MEDICA NEUROTICS. 

Menthol {Mint- Camphor) is obtained by the fractional distillation of the oil of 
peppermint, and to it the oil owes its peculiar odor. It occurs in colorless prisms 
which are said to correspond to the Chinese solid oil of peppermint. It has, of late 
years, been extensively used as an anodyne application in the treatment of neuralgic 
pains, especially those occurring in the supra-orbital and temporal regions, but is 
equally efficient in neuralgias affecting other regions. It is also recommended for the 
relief of rheumatic pains. It is found in the shops in cones or pencils under the 
name of Menthylene, etc., but the best preparation for external use is a solution in 
alcohol ( gj of the pure crystals to f^ss) painted over the part with a brush (H. M.). 

A. Rosenberg* uses menthol 20 parts to ether 100, or 50 of alcohol, as a substi- 
tute for cocaine to produce local anaesthesia of the nasal cavities and pharynx. He 
finds that it quickly induces anaemia of the mucous membrane and diminution of 
sensibility. 

Braddon f has recently called attention to the antiseptic prop- 
erties of peppermint oil, and he experimentally found it (up to 
1 to 3000) to be superior, in the prevention of decomposition, 
to such agents as corrosive sublimate and carbolic acid. For 
minor surgical operations he used successfully gtt. j to olive oil 
f 5j soaked in lint. The results obtained by him with the inha- 
lation of the pure oil, as a germicide in phthisis, are scarcely 
conclusive, though in some cases it seemed to be beneficial. The 
oils may be given in doses of gtt. j-v ; but they are usually ad- 
ministered in the form of spirit in the dose of gtt. x-xx-xl. Two 
waters are also officinal (aqua menthce piperita and aqua mentha 
viridis, both much used as vehicles). The oil of peppermint is 
the stronger of the two, and is strongly recommended as an 
anodyne application in allaying neuralgic pains in herpes zosterj. 
Troches of peppermint are made by rubbing up oil of peppermint 
with sugar and mucilage of tragacanth. 

Vinum Aromaticum {Aromatic wine) is made by percolation, 
and contains I part each of lavender, origanum, peppermint, rose- 
mary, sage, and wormwood, with sufficient stronger white wine 
to make the filtered liquid weigh 100 parts. 

Rosmarinus {Rosemary). Rosmarinus officinalis, or Rose- 
mary, a European evergreen shrub, cultivated in our gardens, 
contains a very stimulant volatile oil (oleum rosmarinus) which is 
chiefly used as an ingredient of rubefacient liniments. It is also 

* Central, fiir gesamt. therap., Oct., 1886, p. 441,. 

f The Lancet, March, 1888, pp. 512, 567. 

\ The Practitioner, London, August, 1882, Meredith. 



STIMULANTS SWEET ORANGE-PEEL. 225 

used in making spiritus odoratus (cologne water). The leaves 
are used. They enter into vinum aromaticum. 

Hedeoma {Pennyroyal}. Hedeoma pulegioides, or Pennyroyal, 
is an indigenous annual plant, about a foot high, with oblong 
lanceolate, serrated leaves, and small, pale-blue flowers arranged 
in axillary whorls. The leaves and tops are used, which con- 
tain a light-yellow essential oil, similar in properties to the mint 
oil, but somewhat more powerful. A body, termed hedeombl 
(C 10 H 18 O), has been extracted from the oil by Franz,* of which it 
constitutes 33 per cent. 

Origanum. The herb of Origanum vulgare, or common 
Marjoram. The essential oil is an ingredient in stimulating 
liniments, but is not officinal. Origanum enters into vinum 
aromaticum. 

Marrubium (Horehound). Marrubium vulgare possesses mild, 
stimulant, tonic and expectorant properties, and, in large doses, 
proves laxative. It is used chiefly in cough syrups and candies. 
The leaves and tops are employed. 

Salvia {Sage). The leaves of Salvia officinalis, a European 
plant, cultivated in our gardens, are used as a condiment, and may 
be used in infusion as a gargle in sore throat ; they are slightly 
tonic and astringent, as well as aromatic. It is an ingredient of 
vinum aromaticum. 

Oleum Thymi (Oil of Thyme). The volatile oil distilled from 
the Thymus vulgaris is often substituted for oil of origanum, 
and is used as an external application. The oil of thyme con- 
sists of cymene (C 10 H 14 ), thymene (C 16 H 16 ), and thymol (C 10 H 14 O), 
occurring in highly aromatic colorless crystals, and has been 
found a valuable antiseptic and antifermentative agent (see Anti- 
septics). 

The following aromatic seeds are derived from plants of the 
natural order Umbellifer^e : — 

Fceniculum (Fennel). The fruit of Fceniculum vulgare, a 
European plant, cultivated in our gardens. It may be used in 
infusion; the dose of the oil is gtt. v-xv. Fennel water is 
officinal. 

* Am. Jour, of Pharm., April, 1888, p. 161. 
15 



226 MATERIA MEDICA NEUROTICS. 

Carum {Caraway). The fruit of Carum Carvi, a European 
plant, cultivated in this country. Dose of the oil, gtt. j-x. 

Anisum (Anise). The fruit of Pimpinella anisum, cultivated 
throughout the south of Europe. Dose of the oil, gtt. v-xv. 
Anise-water (aqua anisi) and spirit of anise are also officinal. 

Coriandrum (Coriander). The fruit of Coriandrum sativum, 
an annual plant of the south of Europe. The oil is officinal. 

Illicium (Star anise). The fruit of the Illicium anisatum 
(Nat. Ord. Magnoliaceae), an evergreen tree of China and Japan, 
is officinal. It contains a volatile oil (which is chemically iden- 
tical with the oil of anise, but has a slightly different odor and 
taste),/^, resin, etc. (Maisch). The oil possesses analogous prop- 
erties to those of the oil of anise, and is much used as a substitute 
for it. 

VANILLA. 

This is the fruit of Vanilla planifolia (Nat. Ord. Orchidaceae), 
a climbing plant of Cuba and Mexico, cultivated also in various 
parts of tropical America, in the Mauritius, Reunion, and Java. 

The pods, when gathered, are yellow, but by exposure to the 
sun they assume a dark copper color. They are cylindrical, 
somewhat flattened, wrinkled, six or eight inches long, three or 
four lines thick, and contain a soft black pulp, in which numerous 
small black seeds are embedded. Vanilla has a strong charac- 
teristic, highly pleasant odor, and a warm, aromatic, sweetish 
taste; the interior pulpy portion is most aromatic. The odorous 
principle of vanilla is a crystalline substance termed vanillin 
(C 8 H 8 3 ), which can be made synthetically from coniferin ; it is 
found only in the interior and not in the exterior fleshy portion. 
It is a mild diffusible stimulant, chiefly used, however, as a per- 
fume and flavoring ingredient. The tincture is officinal. 



ORDER VII. SEDATIVES. 

Sedatives are medicines which diminish the frequency of the 
action of the circulation. They are employed therapeutically to 
reduce excitement of the vascular system. 

With sedatives may be included also the medicinal agents 
termed refrigerants, comprising nearly all the neutral alkaline 
salts, as well as those in which the acid predominates, and the 



SEDATIVES ACONITE. 227 

vegetable acids. These substances have little power of dimin- 
ishing the ordinary or healthy temperature ; but they lower 
febrile heat, allay thirst, restore the secretions, and in this way 
are Very useful adjuvants in the treatment of febrile complaints. 

ACONITUM ACONITE. 

Aconitum Napellus, Aconite, Wolfsbane, or Monkshood {Nat. 
Ord. Ranunculaceae), is a native of the mountainous parts of 
Europe and Asia. The tuberous root is the officinal portion. 
They are brought from Europe, India, and Japan, and other 
species of Aconitum than A. Napellus furnish some of the aconite 
of commerce. Their taste is bitterish and acrid, and when 
chewed they occasion a peculiar feeling of tingling and numbness 
in the tongue and interior of the mouth. These properties are 
impaired by long keeping, when the plant loses its medicinal 
efficacy. The active principle of aconite is an alkaloid named 
aconitine (C^H^NO^). Four other alkaloids, pseiidaconitine 
(CajH^NOn), aconine (C^H^NOu), pseudaconine (C 2 7H 41 N0 8 ), and 
picraconitine (C 31 H45NO 10 ), have been found in it, but the chem- 
istry of aconite is not well settled. 

Aconitine exists in combination with a peculiar acid termed 
aconitic, and is prepared from an aqueous solution of an alco- 
holic extract of aconite-root, by the addition of sulphuric acid 
(which converts the natural salt of aconitine into a sulphate). It 
is a white amorphous powder, with a tinge of yellow (though it 
has been obtained in crystals), without smell, of a bitter, acrid 
taste, and produces in the mouth a sense of numbness. It is 
partially soluble in water, and is readily dissolved by alcohol and 
chloroform, less readily by ether. There is no characteristic 
chemical test for aconitine, but a strong aqueous solution of 
hydrobromic acid saturated with bromine throws down the aco- 
nite salts, or aconite itself, as a yellow precipitate, even if it be 
present in minute quantity ( 25 ^ 00 , Wormley). In medico-legal 
cases, the physiological test, by producing numbness and tingling 
of the lips or skin, must be resorted to. As aconitine is easily 
decomposed, the commercial article is more or less impure. 

Wright and Luff* isolated from the roots of Japanese aconite only one alkaloid, 
* Journal of Chemical Society, vol. I, p. 387, 1879. 



228 MATERIA MEDIC A NEUROTICS. 

japaconitine, which can be split into japaconine, both of which closely resemble 
aconitine and aconine in physical properties. 

/ 

Aconitine is an exceedingly virulent poison, more powerful 
when pure than hydrocyanic acid. It is scarcely adapted to 
internal use, as even gr. -^ has produced alarming results. Mor- 
son's aconitine, prepared from the cultivated A. Napellus, is 
terribly potent, even gr. yoVo" producing numbness of the tongue 
(B). In several instances a drachm of the tincture of aconite has 
destroyed life. 

Physiological Effects. — Aconite applied locally causes a sensa- 
tion of numbness and tingling, induced by its benumbing effect 
on the sensory nerves. The following account of the action of 
aconite is based on the investigations of Mackenzie,* Laborde et 
Duquesnel,f and of Plugge.J Nervous system : taken in small 
doses aconite exerts no influence upon the cerebrum, but its taste 
is pungent and benumbing, and it produces a feeling of numb- 
ness in the head, face, and extremities. Aconite has no action 
upon the motor nerves, the loss of reflex action caused by it 
being due to paralysis of the sensory end-organs, extending to 
the nerve-trunks, and finally to the spinal sensory centres. The 
motor spinal centres are only involved when total palsy has set 
in. Circulation : aconite exerts a marked influence on the circu- 
latory apparatus. Small doses reduce the heart's action and 
lower the arterial pressure ; lethal doses stop the heart in dias 
tole. Aconite applied directly to the heart slows it so that it 
may be concluded that the drug is a cardiac poison acting on its 
motor ganglia. It is also believed to stimulate the cardiac in- 
hibitory apparatus. According to the researches of Ringer 'and 
Murrell, aconite paralyzes all nitrogenous tissues, and it is in 
this way that the heart's beats are retarded. In other words, it 
acts directly against the heart's contained motor apparatus. 
Respiration : these movements tend to become slow, and the 
temperature is lowered. Secretions : aconite increases the secre- 
tion of the skin and kidneys, and is probably eliminated by the 
latter. In larger doses, its effects are those of an acro-narcotic 
poison, the symptoms being a burning or benumbing sensation 

* The Practitioner, XX, 1878, pp. 100, 185. 

f Revue de Med., iii, 1883, p. 804. % Ibidem, p. 1045. 



SEDATIVES ACONITE. 229 

in the mouth, throat, and tongue, followed by gastric irritation, 
spasmodic purging, short, shallow, and superficial respirations, 
contraction or expansion of the pupils, though dilatation is the 
rule ; numbness or paralysis of the limbs ensues, the skin is cold 
and clammy, convulsions set in, the pulse fails, and death results 
from syncope. Aconitized animals remain conscious until death 
takes place. In case of poisoning, the stomach is to be thoroughly 
evacuated, and cardiac stimulants, externally and internally, are 
to be freely administered. The object of physiological antidotes 
being to keep the heart acting, hypodermics of atropine sulphate 
and aqua ammoniae will be found powerful excito-motors for this 
purpose. Digitalis is advised by Fothergill. 

Medicinal Uses. — Aconite is a powerful remedy in the treatment 
of neuralgiae, especially when the 5th pair of cranial nerves are 
affected. It is often combined with quinine in these cases, and 
should be given in doses sufficient to produce its characteristic 
physiological effects to a slight degree. A local application of 
the tincture or of a liniment or ointment is often resorted to with 
advantage, while the drug is administered internally. 

From its influence on the circulation it is applicable to those 
cases of inflammation in which general bloodletting was formerly 
resorted to with advantage, as it reduces the pulse-rate and lowers 
arterial tension, at the same time lowering the temperature and 
causing diaphoresis and diuresis. 

Thus it is used in all cases of sthenic inflammatory fever, 
occurring in robust young adults with a full, tense, bounding, 
strong and frequent pulse, and does most good before the effu- 
sion of inflammatory products has taken place. It is contra-indi- 
cated in typhoid conditions of the system, where the heart is 
weak or where there exists any acute inflammation of the gastro- 
intestinal mucous membrane. 

In surgical fever it is better given in small doses, frequently 
repeated until its effects on the pulse are manifested, when the 
interval between the doses should be increased, and it may be 
administered either alone or combined with other remedies, as in 
the following fever mixture : 1^ Morphinae sulphatis, gr. j-ij ; 
tincturae aconiti, f^xxiv; potassii acetatis, Sss ; spiritus aetheris 
nitrosi, f5yj ; liquoris ammonii acetatis, f^iss; syrupus limonis, 
ad., fohj. M. S. — f 5j in water every 2, 3 or 4 hours as indicated. 



23O MATERIA MEDICA NEUROTICS. 

Aconite may be prescribed in this way and for these effects, 
not only in surgical fevers but also in idiopathic inflammatory 
conditions, provided the indications for its employment are 
present. In acute tonsillitis it will not infrequently cut short the 
attack if administered in time ; in acute pharyngitis, acute laryn- 
gitis or acute catarrhal bronchitis, it is of undoubted value when 
given early, in small doses and frequently repeated. An incipient 
coryza may be aborted by the timely use of aconite, given as 
above, until the pulse is reduced in volume and frequency, 
although for this purpose veratrum viride is generally preferred. 
In the early stages of acute otitis media, much relief is afforded 
by a combination of aconite with morphine and potassic bromide, 
and the external application of heat. In certain diseases of the 
respiratory organs, aconite is of great value, not only from its 
action on the circulation, but because it slows the respiratory act. 
Thus in acute pleurisy before the stage of effusion has been 
reached, if the patient be strong and robust and the pulse is full 
and bounding, tincture of aconite gt. j should be given every 
1 5 or 20 minutes, until the pulse is influenced, while morphine (gr. 
-g— J) should be administered hypodermically, and wet or dry cups 
freely applied to the affected side, followed by a large poultice. 

In acute catarrhal pneumonia aconite is also beneficial, and 
even in the first stage of lobar pneumonia it may be cautiously 
administered combined with some of the ammonium salts, but 
it must be discontinued as soon as effusion has taken place. It 
possesses no advantage over veratrine in these cases, and the 
latter is probably the safer remedy. 

In phthisis, when the disease tends to spread, it may be given 
cautiously, to reduce the pulse rate and moderate the fever. 

In acute peritonitis aconite is of the greatest value and should 
be combined with large doses of opium. In those forms of 
peritonitis occurring during the puerperal period and due to 
septic infection, aconite is contra-indicated, a supporting and 
antiseptic plan of treatment giving better results {vide p. 148). 

In acute cerebral or acute spinal meningitis aconite is also of 
great value. It is indicated in many of the essential fevers, as 
in febricula, in which disease a fever mixture containing aconite, 
and the administration of small doses of calomel, frequently cut 
short the attack. 



SEDATIVES ACONITE. 23 I 

To moderate the excessively rapid pulse of scarlatina, as well 
as for its antipyretic, diaphoretic and diuretic action, aconite is of 
the greatest utility. In measles, also, and in sthenic cases of 
medical erysipelas it has been advantageously employed. 

In the early stages of cerebro-spinal fever before exudation has 
taken place, it may be given with large doses of opium and 
potassic bromide, while the local abstraction of blood by leeches, 
followed by cold to the head and neck, is employed. 

To moderate the fever in the hot stages of intermittent and 
remittent fever, aconite is also used, and in the latter affection is 
often efficacious in relieving the intense headache which so fre- 
quently accompanies this stage. 

From its effects on the heart itself aconite is of the greatest 
value in cases of cardiac hypertrophy when not compensatory 
to valvular lesion. In cases of simple hypertrophy and over- 
action it is our most available remedy combined with rest in the 
recumbent posture, but should any valvular disease exist, great 
caution must be exercised in prescribing it. In cerebral con- 
gestion of active type, by diminishing the force and frequency of 
the cardiac contractions, it proves most beneficial. 

It has also been resorted to in the treatment of internal aneurism. 

Aconite is recommended in suppressio mensum from taking 
cold, but is not always successful. 

In congestive dysmenorrhea it has also been employed, but 
possesses no advantage over other remedies. 

It has also been recommended to check the vomiting of preg- 
nancy. 

As a topical anodyne, aconite, as might be inferred from its 
local benumbing action, is a most useful remedy in neuralgias 
and chronic rheumatism, either painted over the part in the form 
of tincture or applied as a liniment or ointment, and sometimes 
when thus used it has a marked beneficial effect. Admixture 
with chloroform aids the absorption of its alkaloid, and thus 
enhances its effect ; but when thus used it should be employed 
with care and not applied to too large a surface for fear of too 
rapid absorption.* 

*"A Text-Book of Pharmacology, Therapeutics and Materia Medica." By T. 
Lauder Brunton, m.d., etc. London : 1885, p. 753. 



232 MATERIA MEDICA NEUROTICS. 

Aconitine has been used internally and locally in the treatment 
of tic douloureux and other forms of trigeminal neuralgia. 
Duquesnel's aconitine is preferred for internal administration in 
doses* of gr. 3 ^ ' 1 ^ . It is a very active poison, and if employed 
at all, should be used with the greatest care. 

Locally, it is used in neuralgiae, as sciatic, or facial, in alcoholic 
solution (gr. j-ij to alcohol f5j), or as an ointment (gr. ij to 
lard 5j, rubbed up with alcohol gtt. vj). When applied to the 
temple or brow great care should be exercised to prevent any 
from coming in contact with the conjunctiva, as absorption from 
the membrane is very rapid and may occasion poisoning. 

Administration. — The dose of the powdered root is gr. *^ to j ; 
of the abstract, gr. y 2 to j ; of the fluid extract, ^ |— iij ; of the 
extract (alcoholic), gr. %-% ; of the tincture, which is by far 
the best preparation (400 parts of the powder are contained 
in 1000 parts of the tincture), *% J^-v. These doses are to be 
repeated twice or thrice daily, and cautiously increased till the 
effects of the medicine are apparent, or in acute febrile affections 
the smaller doses may be given and repeated every 15 to 30 
minutes until the pulse is influenced or diaphoresis occurs. The 
tincture may be used externally. 

VERATRUM VIRIDE. 

Veratrum viride, known as American Hellebore, Swamp Helle- 
bore, Poke-root, Indian Poke, etc., {Nat. Ord. Melanthaceae), is a 
swampy plant, indigenous to the eastern portion of the United 
States, growing to the height of from three to six feet. The 
rhizome and rootlets are the officinal portions. The rhizome 
is an inch or two in length, thick and fleshy, with numerous 
yellow rootlets, and is found usually in the shops in slices or frag- 
ments, externally of a blackish color and internally of a dingy- 
white color. It is inodorous, but has a bitter, acrid taste, which 
leaves a permanent impression on the mouth and fauces. For 
use, attached portions of the dried stem should be rejected, as 
they are inert. 

C. L. Mitchell's * analysis of this rhizome shows it to contain 
veratroidine and jervine (the latter found also in V. album), rubi- 

* Proceedings Am. Pharm. Associat., 1 874, p. 397. 



SEDATIVES VERATRUM VIRIDE. 233 

jervine, pseudojervine, with resin and oily matter. Some authori- 
ties state that it contains also veratrine (Wormley), but this is still 
an open question. Veratroidine is a white, uncrystallizable pow- 
der, of a bitter taste, leaving a tingling sensation in the fauces, 
soluble in alcohol, ether and chloroform. Jervine is a white, 
tasteless powder, which will crystallize from an alcoholic solution, 
insoluble in water and ether, and freely soluble in alcohol and 
chloroform. 

Physiological Action. — Veratroidine is an emetic, and sometimes 
a cathartic, and a depressant to the circulation. Nervous sys- 
tem : in animals poisoned by veratroidine, twitching and finally 
convulsions are produced ; the reflex spinal centres are at first 
depressed, afterward paralyzed. Circulation : applied directly to 
the heart, it paralyzes the cardiac muscle When given hypo- 
dermically* to animals, it at first lessens the rapidity of the pulse 
and lowers the arterial pressure (due to stimulation of the inhibi- 
tory nerves) ; soon, however, the heart's beat becomes greatly 
increased in force, but not in frequency, and the blood pressure 
falls to normal ; then suddenly the pulse becomes very rapid, 
and the cardiac force is lessened (due to peripheral paralysis of 
inhibitory nerves), and the tension rises much above the normal 
(caused by increasing asphyxia). Respiration : in animals 
poisoned by veratroidine, death is caused by asphyxia, due to 
paralysis of the respiratory muscles. Muscular system : there is 
great muscular weakness in poisoned animals. Gastro-intestinal 
tract : veratroidine is an irritant, causing violent vomiting and 
purging in poisoned animals. 

Jervine produces general weakness (without, however, vomiting 
or purging), lowering of arterial pressure and slowness of the 
pulse, profuse salivation, and finally convulsions. Locally, jervine 
is a feeble irritant. Nervous system : the effects of jervine are 
similar to those of veratroidine, but, in addition, the vaso-motor 
nerves are paralyzed. Circulation f : when applied directly to the 

According to Wright and Luff % the alkaloids of veratrum viride are essentially jer- 
vine, pseudojervine, cevadine, with a trace of veratrine and veratalbine, cevadilline 
being absent; of veratrum album, pseudojervine, jervine, veratalbine, rubijervine, 
and veratrine (a trace). 

* Phila. Med. Times, Vol. iv. H. C. Wood. | Ibid - 

% Journal of Chemical Society, Vol. I, 1 879, p. 405. 



234 



MATERIA MEDICA — NEUROTICS. 



Fig. 17. 




VERATRUM VIRIDE. 



SEDATIVES VERATRUM VIRIDE. 235 

heart (of the frog), it paralyzes it. When an animal is poispned 
with jervine, the frequency of the pulse is diminished, and the 
arterial pressure falls greatly, due to the direct action of the drug 
on the cardiac muscle, as well as to paralysis of the vaso-motor 
centres. Respiration : death takes place from asphyxia. The 
alkaloids exist, in both V. viride and album, in but small propor- 
tions, and can scarcely be profitably extracted. 

The effects of veratrum viride are similar to those of its alka- 
loids. It is an active local irritant. Taken internally, it some- 
what promotes the flow of urine, and in doses of about five 
grains, proves emetic. In continued doses it produces a marked 
sedative action on the circulation, irrespective of the nausea induced, 
which, indeed, may be prevented by careful administration, and 
the temperature of the body is much lowered. It has not generally 
proved laxative. A few fatal cases are recorded from its use — 
though stimulants almost invariably counteract any excessive 
sedation. Recovery has taken place after fSj of the tincture had 
been swallowed, while f3j of the tincture has destroyed life,* and 
in another case| about ^xxx proved fatal. 

Uses. — Veratrum viride is used principally as a cardiac and 
vaso-motor depressa?it. In pneumonia, in which the danger is 
chiefly from failure of cardiac power, the use of veratrum requires 
caution and is serviceable in the early stage only, before exuda- 
tion has taken place. It is also useful in cardiac affections, as 
over-action of the heart, or hypertrophy unaccompanied by valvu- 
lar disease. In active hemorrhage and in acute congestions gen- 
erally it is also of value as a sedative. It has been recommended in 
puerperal eclampsia^, on account of its depressing influence on the 
reflex centres of the cord (Fordyce Barker, Boyd, N. L. Guice, 
etc.); it should be given in doses sufficiently large to reduce the 
pulse to 60 or 80 beats per minute and this effect should be main- 
tained. A few drops of the tincture repeated every hour or two, 
according to the condition of the pulse, will abort an ordinary 
" cold in the head," if given early enough (H. M.). The pre- 
parations of veratrum viride should only be given to strong, 
robust patients, and must never be made use of in any asthenic 

* Med. Times, Aug., 1884, p, 863. 

f Med. ana Surg. Reporter, May, 1873, p. 379. 

\ Canadian Practitioner, March, 1 885, p. 366. 



236 MATERIA MEDICA NEUROTICS. 

disease. Dose, of the powder, gr. j-ij to begin with ; of the 
tincture, gtt. v-x ; of the fluid extract, gtt. iv-v. 

Veratrina {Veratrine) (C 3 2H 52 N 2 8 ) is an alkaloid or mixture 
of alkaloids obtained from the seeds of Asagraea officinalis {Nat. 
Ord. Melanthacese), an herbaceous plant of Mexico, which con- 
tains no jei'via* It is made by evaporating a strong tincture of 
the seeds to the consistence of an extract, from which the alka- 
loid is dissolved by diluted sulphuric acid, and afterward pre- 
cipitated by magnesia. When pure it is white, but it is usually a 
grayish or brownish-white powder, without odor, but very irri- 
tant to the nostrils, and of a bitter, acrid taste, producing a sense 
of tingling or numbness in the tongue ; scarcely soluble in cold 
water, but readily soluble in alcohol, and of an alkaline reaction. 
A delicate test for veratrine is Trapp's — a permanent lilac-red 
color, resembling a solution of potassium permanganate, afforded 
by boiling it in hydrochloric acid. 

Physiological Effects. — Locally, veratrine acts as an irritant,f 
producing heat, pain, numbness, and perhaps redness in the part 
to which it is applied. Nervous system : its action on the brain 
is not marked, and the reflex excitability of the spinal cord is 
diminished in animals after the administration of a large dose 
(Ott). Veratrine acts as a direct poison upon nerves (Ott, Wood, 
H. C, etc.), but whether it affects the nerve-trunk or its end- 
organs is still sub judice. Circulation and blood : in animals, small 
doses stimulate the excito-motor cardiac ganglia and increase the 
frequency of the cardiac beat ; large doses stimulate the pneumo- 
gastric nerve, and as the excito-motor ganglia become exhausted, 
the cardiac beat is slowed. It also poisons the cardiac muscle. 
It probably paralyzes the central vaso-motorj apparatus eventu- 
ally. The blood pressure is, at first, elevated, then lowered, and 
the blood is rendered less coagulable. Respiration and tempera- 
ture ; small doses increase, while larger doses diminish, the fre- 
quency of the respiratory movement, and the temperature is low- 
ered. It destroys life by paralysis§ of respiration. Excretion : 

* Proceed. Am. Pharm. Associat., 1874, p. 397. C. L. Mitchell. 
f Bull. Gen. de Therap., cv, 430. Sur Paction physiologique de veratrine. 
% Arch, fur Exper. Pathol, u. Pharmakol., 1 887, p. 36. Untersuchungen liber die 
Wirk. der Veratrumalkaloide, von H. Lissauer. \ Ibid. 



SEDATIVES PASQUE-FLOWER. 237 

the excretions from the skin and kidneys are increased. Gastro- 
intestinal tract : in large doses it is an irritant poison, causing 
severe Vomiting and purging.* Muscular systemf : muscular 
irritability is at first exalted (producing convulsions), but is after- 
ward entirely lost. HeatJ increases and cold lessens the effects 
of veratrine on muscle. Its toxic action§ is comparable to that 
of its congeners. Elimination : it is eliminated by the kidneys. 

Stimulants and ethereal inhalation would be the proper treat- 
ment in cases of poisoning. 

Uses. — Veratrine is rarely used internally; the dose is gr. ^ to 
\ repeated ; it is most used externally, in the form of ointment (4 
parts, to alcohol 6 parts, and benzoinated lard 96 parts) ; or dis- 
solved in alcohol, as an application to rheumatic and neuralgic 
parts. Oleatum veratrince (veratrine oleate) consists of veratrine 
2 parts, to 98 parts of oleic acid. 

PULSATILLA PASQUE-FLOWER. 

The herb of Anemone pulsatilla, Anemone pratensis and 
Anemone patens (Nat. Ord. Ranunculaceae), is found in both 
hemispheres. It should be collected soon after flowering and 
carefully preserved, but should not be kept more than a year. 
It contains an acrid volatile oily substance, easily converted into 
anemonin, Cj 5 H 12 6 , and anemonic acid, C ]5 H 14 7 (Maisch). 

Physiological Effects. — Locally, fresh pulsatilla is an irritant, and 
after prolonged contact with the skin may cause inflammation, or 
even gangrene. When the powder is inhaled, it produces itching 
of the eyes, colic, vomiting, diarrhoea, etc. (Phillips). Nervous 
system : motor and sensory paralyses are produced in animals by 
large doses, but how they are produced has not been ascertained. 
After poisonous doses, dilatation of the pupil, sopor, coma, and 
convulsions occur. Circulation : pulsatilla is a cardiac depres- 
sant, and lowers the arterial pressure. Respiration and tempera- 
ture : it slows the respiration (Clarus), and reduces the tempera- 
ture. Gastro-intestinal tract: it is an irritant poison, in large 
doses producing vomiting and purging. Elimination : probably 



* Bull. Gen. de Therap., cv, 430. Sur Taction physiologique de la veratrine. 

f Journal de P Anatomie et de la Physiologie, 1868, p. 206. 

\ The Journal of Physiology, Vol. iv, p. I. \ Bull. Gen. de Therap., etc. 



238 MATERIA MEDICA NEUROTICS. 

takes place through the kidneys. Incompatibles : caustic alka- 
lies, tannic acid, and metallic salts. 

Medicinal Uses. — Pulsatilla, owing to its irritant action on the 
digestive tract, is not well borne, and, moreover, possesses no 
superiority over more efficient sedatives like aconite. 

The powdered herb may be given in doses of gr. ij-v, or an 
extract or tincture may be made. 

ARNICA. 

Arnicae Flores, Arnica Flowers ; Arnicae Radix, Arnica Root. 

Arnica montana, Leopard's Bane {Nat. Ord. Composite), is a 
perennial herbaceous plant, found in northern Germany and other 
northern countries of Europe, and also in the northwestern por- 
tions of America. The flower heads and the rhizome and 
rootlets are the officinal portions. Both contain volatile oil, 
arnicin, resins, etc. ; the root contains, in addition, inulin and 
tamiin. 

Effects and Uses. — Locally, arnica is a stimulant and often an 
irritant to the skin. The internal effects of this drug are not 
well understood. Large doses cause headache and dilatation of 
the pupils ; poisonous doses paralyze the nervous system, and 
death ensues from collapse. Moderate doses lower (in dogs) 
the pulse by stimulating the pneumogastrics peripherally and 
centrally, raise slightly the arterial pressure, and depress the 
respiration and temperature. (H. A. Hare.*) Small doses are 
said to excite the action of the skin and kidneys. In large 
amounts it is an irritant to the gastro-intestinal tract, producing 
nausea, vomiting and purging of a choleraic character, and also 
great muscular weakness. 

In this country it is principally used externally, in the form of 
fomentation or lotion, for the relief of bruises, sprains and local 
paralysis. The extract of the root [alcoholic) is given in doses of 
gr. v-x. This is chiefly used, however, in making a plaster (em~ 
plastrum arnica). The fluid, extract of the root is given in doses 
of "n^x-xx. The tincture of the root and the tincture of the flowers 
may be given in doses of ^v-xxx. They are often used 
externally combined with soap liniment. In applying arnica 

* Boston Med. and Surg. Journ., Jan. 12th, 1888. 



SEDATIVES PHYTOLACCA. 239 

externally, the irritating qualities of the drug should be brorne 
in mind. 

PHYTOLACCA. 
Phytolacca Bacca, Phytolacca Berry ; Phytolacca; Radix, Phytolacca Root. 

Phytolacca is the fruit and root of the Phytolacca decandra 
(Nat. Ord. Phytolaccacese), commonly known as Poke-Berries and 
Poke- Root. It is a perennial herb, indigenous to North America, 
growing to the height of four to eight feet, and found in waste 
places. The young stems, collected in the spring and boiled, are 
sometimes eaten at table. The root contains resin, starch, tannin, 
etc. ; the berries contain sugar, gum, coloring matter, etc. An 
indifferent crystalline principle termed pliytolaccin has been iso- 
lated, by Claassen. * Partee, f in a recent analysis of the root, 
could detect no alkaloid. 

Effects and Uses. — Phytolacca paralyzes the motor centres of 
the cord and medulla. In overdoses it causes dimness of vision, 
coma and sometimes convulsions (Stille and Maisch), and death 
is produced by paralysis of the respiratory centre. Phytolacca 
depresses the cardiac action and respiration, and produces nausea 
and vomiting, which does not take place until about an hour after 
the drug is administered, and which is accompanied by great de- 
pression. Purging also takes place, and Rutherford found it to 
be a powerful hepatic stimulant, increasing the secretion of bile. 
It is eliminated by the kidneys. 

Phytolacca has been used with success as an alterative in the 
treatment of rheumatism of syphilitic origin (Stille and Maisch). 
It is useful in phlegmons J of the breast, to allay the inflam- 
mation and prevent suppuration, and possibly may exert a like 
influence on other inflamed glands. 

It is recommended as a local application to leg ulcers (Tidd §) 
and eczema, and also in scabies and tinea capitis||. It should not 
be used as an emetic, because of the great depression which it 
induces. Dose of the powder, gr. j-xxx; or a tincture (ojv-Oj), 
or fluid extract may be used, dose ^v-f5j. For local use, an 



* The Pharmacist and Chemist, 1879, p. 466. 

f Am. Jour n. of Pharmacy, March, 1888, p. 123. 

% Am. Jour. Med. Sci., 1873, p. 275. \ The Clinic, Vol. v, p. 273. 

|| J. Bigelow, quoted in Piffard's " Mat. Med. and Therap. of the Skin." 



240 MATERIA MEDICA NEUROTICS. 

ointment may be prepared (5j-oj). These preparations are not 
officinal. 

STAPHISAGRIA. 

Staphisagria, Stavesacre or Licebane is the seed of the Del- 
phinium Staphisagria {Nat. Ord. Ranunculaceae), a beautiful 
biennial plant, with terminal racemes of blue flowers, native 
of southern Europe. It contains three alkaloids, delphinine 
(C 2 4H35N02o), delphinoidine and delphisine, and staphisain 
(C 16 H23N0 2 ) ; also fixed oil, etc. 

Physiological Effects. — When applied to the skin delphinine acts 
as a rubefacient and even irritant. When given internally to ani- 
mals it causes convulsions, and finally clonic spasm ; the reflex 
centres of the cord are palsied (Cayrade,* and cutaneous anaes- 
thesia is produced (Falck and Rorigf), and finally the respiratory 
centre is paralyzed, causing death from asphyxia. The effects 
on the circulation are most marked. It slows the cardiac action 
and paralyzes the heart by a direct action on its muscle and 
nervous supply (Falck and R6rig,J L. Van Praag). It causes 
dyspnoea, slows the respiratory movements and paralyzes the 
voluntary muscles. It causes salivation and induces vomiting 
(an early symptom), due to irritation of the end-organs of the 
pneumogastric nerves. It is eliminated by the bowels and kid 
neys, producing constipation and difficult urination during 
excretion (Albers,§ Schroff||). Staphisain also causes death by 
asphyxia ; but its action on the nervous system and circulation 
is said to be less marked. 

Medicinal Uses. — It is chiefly used as a local parasiticide in 
phthiriasis and scabies. Dose of the powder, gr. j-iij ; or a 
tincture (i part to alcohol 5 parts — dose ^ x -xv), or fluid extract 
may be used. An ointment (digest 5ij of bruised seed in lard 
0} and strain while hot) is the best form for external use. None 
of these preparations are officinal. 



* Journ. de PAnat. et de Physiol. Mai et Juin, 1869. 317. 

f Archiv. fur phys., Heilkun., 528-548, 1852, and Rorig's Dissert, de Effedu 

Delphini, Marburg, 1852. % Virch. Arch., Bd. VI., 385-448, und 435-457. 

I Allg. Zeitschr. Psych. XV, 348. 1858. || Pharmakologie, 3 aufl.,ip. 547. 



SEDATIVES PREPARATIONS OF ANTIMONY. 24 1 

ANTIMONII PR^EPARATA PREPARATIONS OF ANTIMONY. 

Antimonii Oxidum (Antimonious Oxide) (Sb 2 3 ) is a heavy 
grayish-white, insoluble powder, having the general therapeutic 
properties of the antimonials, and though not quite certain in its 
effects — as its solubility depends on the amount of hydrochloric 
acid which may exist in the stomach — it is believed to produce 
the sedative operation of tartar emetic, with less nausea and 
derangement of the stomach. Dose, gr. ij-iij, repeated. 

Antimonii et Potassii Tartras {Antimonium and Potassium 
Tartrate). This salt, familiarly known as tartar emetic and tartar- 
ized antimony, is prepared by boiling water and cream of tartar with 
antimonious oxide. It occurs in colorless, transparent, rhombic, 
octahedral crystals, which become white and opaque from efflo- 
rescence on exposure to the air. When pure its powder is per- 
fectly white ; but it is to be preferred in the crystalline state, as 
in this form it is less liable to adulteration. In testing for anti- 
mony the metal itself should be reduced, as by Marsh's test (see 
Arsenious Acid). The powder of tartar emetic is sometimes 
adulterated with cream of tartar, which may be detected by 
adding a few drops of a solution of sodium carbonate to a boil- 
ing solution of the antimonium salt, and if the precipitate formed 
be not re-dissolved, no potassium bitartrate is present. 

Tartar emetic (2KSbC 4 H 4 7 .H 2 0) is inodorous ; has a nau- 
seous, metallic taste; is soluble in 15 parts of cold and 3 parts 
of boiling water ; insoluble in pure alcohol ; and is decomposed 
by the alkalies, alkaline carbonates, and the vegetable astrin- 
gents. 

Physiological Effects. — Tartar emetic is a powerful local irritant. 
Applied to the skin, it occasions an eruption of pustules, resem- 
bling those of variola or ecthyma. When taken into the 
stomach, in full doses, it causes vomiting, purging, griping 
pains, etc., and in excessive quantity it acts as an irritant poison, 
and has produced death, with great prostration, syncope, dimi- 
nution of reflex irritability, and even convulsions and delirium : 
very large doses have, however, been given medicinally with 
entire safety. The proper antidote is tannic acid ; and opium, 
stimulants, and demulcents should be also administered. The 
constitutional effects of tartar emetic, when taken internally in 
small doses, are an increase in the secretions and exhalations 
16 



242 MATERIA MEDICA NEUROTICS. 

generally, especially from the skin ; the amount of carbonic acid 
exhaled by the lungs is increased ; the amount of urine excreted 
is lessened, but the urea is much increased (Ott) ; after large 
doses albuminuria is often seen ; in somewhat larger doses, these 
effects are accompanied with nausea and vomiting, relaxation of 
the tissues (particularly the muscular fibres), a feeling of great 
feebleness and exhaustion, and at first a stimulant, later a power- 
ful sedative, action on the circulation and respiration, the cardiac 
action becoming slow, weak and finally irregular, and the arterial 
tension being lowered. It acts on the heart by depressing the 
excito-motor nerves and paralyzing the cardiac muscle. After 
poisonous doses the red blood corpuscles are altered in form, 
and together with the albumen, are diminished in amount, in the 
blood of animals ; the fibrin is increased (Ott). The temperature 
of the body is lowered. In small, repeated doses, continued for 
some time, it produces fatty degeneration of the liver. It is 
eliminated slowly by the bile, milk, perspiration and urine, also 
by the bronchial mucus and the intestinal secretions. The 
minimum fatal dose for an adult is gr. ij ; for a child, gr. ^ 
(Taylor). On the other hand, very large quantities have been 
taken without fatal results. 

Medicinal Uses. — Tartar emetic is employed internally as an 
emetic, sedative, sudorific and expectorant, and locally as a counter- 
irritant. It is to be used with great caution on account of the 
prostration which it produces, and should never be given to 
young children, nor when gastro-enteric inflammation is present. 
It should only be used in sthenic cases in robust adults. As an 
emetic, it creates more nausea and depression than any other 
substance ; and hence, while other emetics are to be preferred 
to it, when our object is merely to evacuate the contents of the 
stomach with as little constitutional disturbance as possible, it is 
of value when vomiting is resorted to as a means of making an 
impression on the system and thereby checking the progress of 
disease. As a sedative antiphlogistic, in large doses it is a most 
powerful remedy in the treatment of acute inflammation, with 
fever, from its combined action in reducing the force and fre- 
quency of the circulation, moderating the heat of the skin, and 
promoting diaphoresis. When given in this way, at intervals, 
tartar emetic ceases to produce emesis, owing to the establish- 



SEDATIVES — PREPARATIONS OF ANTIMONY. 243 

ment of tolerance of the medicine. It is inferior to other seda- 
tives, as aconite, etc. In the early stages of acute laryngitis and 
bronchitis, it is a remedy of great value. From gr. yV~i ma y De 
given every two hours in gradually increasing doses, until some 
amelioration of the symptoms takes place, when the doses are to 
be again decreased ; a favorite combination with many physicians 
is : 1^ Antimonii et potassii tartratis, morphinse sulphatis, aa 
gr. j ; aquae, f§ij. M. One teaspoonful contains gr. -^ each of 
tartar emetic and morphine. As a diaphoretic, it is very useful 
in small doses (as from y 1 ^— J-, repeated), in continued fevers, 
inflammation from wounds, injuries, etc.; and as an expectorant, 
when there is fever, a full pulse, and but little expectoration, as 
in acute bronchitis, in the same doses; it is also employed in 
various pulmonary affections with advantage. As a local irri- 
tant, it is rarely used, and is in many cases injurious. 

Administration, — The dose of tartar emetic, as an emetic, is gr. 
j-ij, and it is frequently combined with ipecac. As a sedative 
antiphlogistic -, gr. ^— \ to gr. j-ij. As a diaphoretic and expectorant, 
gr. T X g— \, may be given in solution, and in each case repeated 
every two or three hours. It is advantageously combined with 
small doses of morphine, when decided diaphoresis is aimed at. 

Vinum Antimonii {Antimonial Wine) is a solution of tartar 
emetic (4 parts) in boiling distilled water (60 parts) and stronger 
white wine (to make 1000 parts). It is employed as an expec- 
torant and sudorific, in the dose of from gtt. x-xxx, frequently 
repeated ; and as an emetic for children, in the dose of gtt. xxx 
to f5j, repeated every quarter of an hour. Other emetics are to 
be preferred. 

Antimonii Sulphidum {Antimonious Sidphide), the native sul- 
phide, purified by fusion, and Antimonii Sulphidum Purificatum 
{Purified Antimonious Sulphide), are used in making the other 
preparations. 

Antimonium Sulphuratum {Sulphurated Antimony) is a red- 
dish-brown, odorless, almost tasteless, insoluble powder, and is 
chemically a mixture of antimonious sulphide (Sb 2 S 3 ) and oxide 
(Sb 2 8 ). Its effects are analogous to those of tartar emetic. 
Dose, gr. j-iij ; as an emetic, gr. v-xx. 

Pilulce Antimonii Composites {Compound Pills of Antimony), 
sometimes called Plummers Pills. They are used as an alterative 



244 MATERIA MEDICA NEUROTICS. 

in rheumatic and cutaneous affections. One pill contains of 
calomel and sulphurated antimony each gr. ss. 

Pitlvis Antimonialis . An antimonial powder is prepared in 
imitation of the cerebral James's powder, by mixing antimonious 
oxide (33 parts) with precipitated calcium phosphate (67 parts). 
It is a white, gritty, tasteless, odorless powder. Dose, gr. iij- 
viij. 

POTASSII NITRAS POTASSIUM NITRATE. 

This salt, commonly called nitre and saltpetre (KN0 3 ), occurs 
in both the inorganic and organic kingdoms of nature. It is 
obtained, for medicinal use, principally by the purification of the 
native nitre of India ; and it is found also in saltpetre caves in 
various parts of the United States, associated with calcium nitrate, 
from which it is separated by lixiviation. It is artificially pro- 
duced in several parts of Europe, in nitre beds or saltpetre plant- 
ations, by bringing together decayed organic animal and vege- 
table matters. And it is manufactured sometimes by the double 
decomposition of sodium nitrate and potassium chloride. Nitre 
is refined by re-solution and crystallization of the crude nitre. As 
purified for medicinal use, it is found in the shops in large, trans- 
parent, colorless crystals, of the form of six-sided striated prisms, 
with dihedral summits, which are unalterable in the air. They 
have no odor, a sharp, cooling taste, are wholly soluble in water, 
and insoluble in pure alcohol. They have no water of crystal- 
lization, but frequently have a portion of the mother liquid 
mechanically lodged in the spaces of the crystals, which may be 
driven off by heat, and the salt fused and cast into moulds, when 
it is termed sal prunelle. 

Physiological Effects of the Potassium Preparations. — As the 
effects of the potassium salts are largely due to their base, it will 
be more convenient to consider them together, pointing out any 
differences when the various preparations are considered. Locally, 
some of this group, as potassa fusa, abstract water from the 
tissues, dissolve albumen and saponify fats, and hence are caustics. 
The nitrate is a violent irritant when applied to mucous mem- 
branes or raw surfaces. Nervous system : in large doses, they 
may produce coma, and they act on the spinal centres, by lowering 
reflex excitability and causing paralysis of the lower extremities 
when given in large amounts. Circulation : all the potassium 



SEDATIVES POTASSIUM NITRATE. 245 

salts are cardiac poisons, their activity being due to the potas- 
sium, and varying with the amount of the base they contain. In 
moderate doses they slow the heart and increase the arterial 
pressure, while in large doses they both diminish the frequency 
of the cardiac pulsations and lower the blood pressure. Animals 
poisoned by them die from cardiac paralysis (the heart being 
arrested in diastole), caused by direct action on the cardiac 
muscle and also by paralysis of the cardiac ganglia. Blood : 
after large doses, or when taken for some time, the blood is found 
to be less coagulable (the fibrin being diminished), the white cor- 
puscles relatively increased, and the venous blood lighter in color 
(Phillips). After large doses of the nitrate or chlorate, the blood 
becomes dark and refuses to take up oxygen, and the hemo- 
globin is decomposed. The compounds with the vegetable acids 
increase the alkalinity of the blood. Temperature is reduced by 
large doses, especially when the nitrate or chlorate has been 
given. Secretion : the alkaline potassium compounds, like alka- 
lies in general, when applied to the orifices of glands with acid 
secretions, increase, but when applied to glands with alkaline 
secretions, diminish, their secreting power (Ringer). This does 
not apply to the nitrate. They increase the water of the urine 
and the urea, and lessen the amount of uric acid. If the bi- 
carbonate is given during fasting, the acidity of the urine will be 
increased, but the urine will be alkaline if it is administered 
during digestion. The alkalinity of the urine is most marked 
after the ingestion of the salts with the vegetable acids (as the 
tartrate, citrate, etc.). The nitrate and chlorate do not affect the 
reaction of the urine. Gastro-intestinal tract : when alkalies are 
given on an empty stomach, the secretion of the acid gastric 
juice is increased ; if given when gastric digestion is in progress, 
they neutralize the acidity of the secretion. In large amounts, 
potassa or the chlorate, nitrate, carbonate or chloride excites vio- 
lent inflammation, causing vomiting, purging, etc. Nutrition : 
alkalies in small doses improve digestion, aid in saponifying fats, 
and promote oxidation of tissue, but when administered for too 
long a time, especially if given in large doses, they cause emacia- 
tion and pervert nutrition. Elimination : the potassium salts are 
eliminated chiefly by the urine, but to some extent also by the 
other secretions. The salts with the vegetable acids, during 



246 MATERIA MEDICA NEUROTICS. 

their passage through the system, are converted into carbonates 
and are eliminated under this form. Potassium nitrate and chlor- 
ate are eliminated unchanged in the urine and as sulphates in the 
faeces. In excessive doses, nitre may act as a fatal poison, pro- 
ducing irritation of the alimentary canal and derangement of the 
nervous system ; the symptoms are burning pain in the throat 
and stomach, bloody stools, a tendency to syncope, collapse, and 
death, sometimes preceded by dilated pupils, insensibility and 
convulsions. There is no antidote for it, and cases of poisoning 
are to be treated by demulcents, opiates, stimulants, etc., after 
evacuation of the contents of the stomach. 

Medicinal Uses. — Nitre is not as much used as it was formerly. 
It may be given as a refrigerant and sedative remedy in fevers, 
inflammations, hemorrhages, etc. In fevers it is sometimes pre- 
scribed with calomel and tartar emetic, under the name of nitrons 
powders (nitre, gr. x ; tartar emetic, gr. \ ; calomel, gr. \ to -J-). 
In large doses it was given formerly in acute rheumatism, and 
this practice has been revived with success in France. It is some- 
times combined with Dover's powder (of each gr. iij-v or viij) in 
the treatment of acute muscular rheumatism. Dose, gr. x-xxx. 
From oiv-vj are given in twenty-four hours, in acute rheumatism, 
and the quantity is increased to 5viij-x, or xij. Charta Potassii 
Nitratis (Potassium Nitrate Paper) consists of strips of white 
unsized paper immersed in solution of potassium nitrate (20 parts 
to 80 parts of distilled water). The inhalation of the fumes 
arising from the burning of these papers is used with advantage 
in spasmodic asthma. 

Sodii Nitras {Sodium Nitrate, NaN0 3 ). This salt, commonly 
called cubic nitre), is found in large deposits in South America, 
chiefly in Peru, but also in Bolivia and Chili. The crude salt 
occurs in rather soft and pliable lumps, of white, yellow or gray 
color ; it is often purified in Peru by solution, crystallization 
and desiccation, but it is usually refined after importation. It 
occurs in colorless rhombohedral crystals, slightly deliquescent, 
and wholly soluble in water, without odor, and of a sharp, cooling 
and bitter taste. 

Effects and Uses. — Sodium nitrate has been little used in medi- 
cine, its employment having been limited chiefly to dysentery, 
in which it is highly praised by German physicians, in amounts 



SEDATIVES SOLUTION OF AMMONIUM ACETATE. 247 

of from oss-j, in mucilaginous solution, during the day. Its 
effects are analogous to those of potassium nitre. The sodium 
salts are not as powerful cardiac poisons, neither do they affect 
the temperature nor act on the nervous system to the same 
extent. They impede coagulation, but do not alter the blood 
corpuscles. 

REFRIGERANTS. 
POTASSII CTTRAS POTASSIUM CITRATE. 

This salt (formerly known as Salt of Riverius) is made by satu- 
rating a solution of citric acid with potassium bicarbonate, and 
evaporating to dryness. It is white, granular, inodorous, of a 
saline, slightly bitterish but not unpleasant taste, deliquescent, 
and wholly soluble in water (K 3 C 6 H 5 7 .H 2 0). It is an excellent 
refrigerant diaphoretic, much employed in febrile affections. 
Dose, gr. xx-xxv ; 3yj are usually dissolved in water Oss, and 
foss of the solution is administered every hour or two. The 
salts of the alkalies with vegetable acids, as citrates, tartrates 
and acetates, during their passage through the body are con- 
verted into carbonates. 

Liquor Potassii Citratis {Solution of Potassium Citrate) may be 
made by dissolving separately citric acid 6 parts and potassium 
bicarbonate 8 parts in water enough to make the combined 
solutions weigh ioo parts; dose, f§ss. 

Mistura Potassii Citratis {Mixture of Potassium Citrate, or 
Neutral Mixture) is made by saturating fresh lemon-juice with 
potassium bicarbonate; or, when the lemon-juice cannot be had, 
a solution of citric acid, flavored with oil of lemon, may be used 
as a substitute. This preparation contains some free carbonic 
acid, which renders it more grateful to an irritable stomach than 
the ordinary solution of the citrate. Under the name of effer- 
vescing dratight the potassium citrate is often prepared extempo- 
raneously (fresh lemon-juice foss with an equal measure of 
water, added to a solution of potassium carbonate 5ij in water 
fSiv), and is given in the state of effervescence ; it is an excellent 
remedy for irritable stomach, with fever. 

LIQUOR AMMONII ACETATIS SOLUTION OF AMMONIUM ACETATE. 

This solution, termed also Spiritus Mindereri, or Spirit of 
Mindererus, is made by saturating diluted acetic acid with 



248 MATERIA MEDICA NEUROTICS. 

ammonium carbonate, and is a solution of ammonium acetate 
(NH4C2H3O2). When pure it is a colorless liquid, with a saline 
taste ; it should always be made freshly when dispensed. The 
physiological effects of the ammonium salts have already been 
considered (vide p. 212). In small doses it is refrigerant ; in 
larger doses, diaphoretic and diuretic. It is employed in febrile 
and inflammatory affections, sometimes in conjunction with nitre 
or one of the sedatives, sometimes combined with camphor and 
opium. Given in full doses, frequently repeated, it is one of the 
best means of removing the effects of drunkenness. Dose, f Sss-j 
every two, three or four hours, in sweetened water. 

SPIRITUS ^THERIS NITROSI SPIRIT OF NITROUS ETHER. 

This preparation, commonly known as Sweet Spirit of Nitre, 
is a solution of ethyl nitrite (C 2 H 5 N0 2 ) in alcohol. Spirit of ni- 
trous ether is a volatile, inflammable liquid, of a pale-yellow color, 
inclining slightly to green, has a fragrant, ethereal odor, free from 
pungency, and a sharp, burning taste, and mixes with water and 
alcohol in all proportions; sp. gr. 0.823 to 0.825. It contains 
five per cent, of nitrous ether. It should not be long kept, as it 
becomes strongly acid by age. 

Effects and Uses. — Sweet spirit of nitre is antispasmodic, refrig- 
erant ^ diaphoretic, and diuretic. As a diaphoretic, small doses 
should be given, largely diluted and frequently repeated. It is 
much used in febrile affections, and, from its diuretic properties, 
is often combined with other diuretics in the treatment of drop- 
sies. From its pleasant taste and smell it is very acceptable to 
children. Dose, f5ss-j, frequently repeated. The inhalation of 
sweet spirit of nitre has produced dangerous and even fatal effects : 
pallor of the face, livid discoloration of the lips and fingers, weak- 
ness of the pulse, muscular prostration, precordial oppression, 
and headache are the symptoms described. A case is recorded 
in which death was attributed to the inhalation of the ether from 
a broken bottle in a sleeping apartment. The same symptoms 
may be produced by excessive doses. 

ACIDA VEGETABILIA VEGETABLE ACIDS. 

The vegetable acids are refrigerant, and, when properly diluted, 
form useful drinks in fevers, etc. Those chiefly employed are 



SEDATIVES VEGETABLE ACIDS. 249 

acidum aceticum {acetic acid), acidum citricum (citric acid), .and 
acidum tartaricum (tartaric acid). 

Effects and Uses. — The following description is based on the 
investigations of H. Bence Jones * and F. Walter, f Applied to 
a raw surface or (if sufficiently concentrated) to the mucous mem- 
branes, they act as irritants. Acetic acid is the most powerful, 
and will, when applied to the skin, cause blanching, from contrac- 
tion of the capillaries. Citric acid is the least irritant. After 
large doses the cardiac beat is slowed and weakened, but this is 
possibly due to the resulting gastro-enteritis. According to 
Walter they do not neutralize the alkalinity of the blood. It is un- 
known under what conditions they exist in this fluid. The 
general law regarding the action of acids on secretion holds good 
in the case of the vegetable acids, viz. : that when applied to the 
orifices of glands secreting an acid fluid they diminish, while 
when applied to glands secreting an alkaline fluid they increase 
their secreting power. Thus they augment the flow of saliva and 
the intestinal secretion. The ingestion of the vegetable acids 
increases the acidity of the urine. They also promote the ex- 
cretion of both the water and the solids of the urine, particularly 
free uric acid (and may thus lead to calculus). Their continued 
use causes abdominal pain, flatulence, and diarrhoea. In large 
doses they produce gastro-enteritis, and continued for a lengthy 
period they induce scorbutic symptoms. 

There are no recorded cases of poisoning with citric acid ; tar- 
taric S/4 is alleged to have caused death in one instance, and 
fatal results from acetic are equally rare.J The antidotes are the 
alkalies. They are probably converted into carbonic acid in the 
system, unite in part with bases to form salts, and are eliminated 
by the kidneys and intestinal mucous membrane. 

Acetic Acid (HC 2 H 3 2 ) is employed internally only in the 
form of diluted acetic acid (strong acid 1 7 parts to distilled water 
83 parts). Externally, strong acetic acid (sp. gr. 1.048, and con- 
taining 36 per cent, of monohydrated acid) or glacial acetic acid 
(nearly absolute acetic acid — sp. gr. 1.058) is employed as an 



* Medical Times and Gazette, Oct. 21st, 1854. 

f Arch, ficr Exper. Pathol, u. Pharm., 1877, p. 148. 

% Medical Press and Circular, Nov. 17th, 1880, p. 417. 



250 MATERIA MEDICA NEUROTICS. 

escharotic to remove warts and in the cure of lupus. Acetic acid 
is less used internally as a refrigerant than citric acid, from its 
liability to produce colic and diarrhoea. Vinegar and water is one 
of the best injections for the cure of vaginal gonorrhoea in the 
female. Spongings with vinegar and water are useful to relieve 
the heat of the skin in fevers, and the vapor is grateful to the sick. 
Concentrated acetic acid is a corrosive poison, for which the alka- 
lies and their carbonates, soap, etc., are the antidotes. Citric 
Acid may be agreeably administered in the diluted juice of 
lemons, limes, sour oranges, and tamarinds. When these cannot 
be obtained, a solution of citric acid (gr. xx to water Oj) may be 
substituted. Citric acid is manufactured from lemon or lime 
juice, by saturating it with calcium carbonate and afterward de- 
composing the calcium citrate which is formed, by the addition 
of sulphuric acid. It occurs in colorless crystals (H 3 C 6 H 5 7 ,H 2 0), 
having the form of rhomboidal prisms with dihedral summits, 
freely soluble in water, and soluble in alcohol ; 5ixss, added to 
distilled water Oj, form a solution of the average strength of lemon- 
juice. In the dose of f 5j every hour or two, lemon-juice, limonis 
succus (the juice of the fruit of Citrus Limonum), has been em- 
ployed with success in acute rheumatism and gout. Of late years, 
however, it has given place to more reliable modes of treatment. 
Properly diluted and mixed with sugar, it forms the delightful 
refrigerant known as lemonade. Lemon-juice (or, still better, 
lime-juice) is the most efficient known remedy for scurvy. It has 
also proved of advantage in jaundice and torpor of the liver. 
Syrup of citric acid consists of citric acid (8 parts) and water 
(8 parts) with oil of lemon (4 parts) and syrup (980 parts). Lemon- 
syrup, which is pleasanter, is made by heating lemon-juice (40 
parts) to the boiling point, adding lemon-peel (2 parts) and letting 
it stand until cool ; then filter and add enough water to make the 
filtrate weigh 40 parts ; dissolve sugar (60 parts) in the filtrate 
and strain. Spirit of lemon (sometimes called essence of lemon) is 
made by dissolving oil of lemon 6 parts (obtained from the rind 
of the fruit), in alcohol 90 parts, and adding freshly-grated lemon- 
peel 4 parts ; dose, f5j-ij. Tartaric Acid is the acid of grapes, 
and is extracted from tartar or crude cream of tartar. It is a 
white crystallized solid, in the form of irregular six-sided prisms 
(H 2 C 4 H 4 6 ), and is found in the shops as a fine white powder. 



SPINANTS NUX VOMICA. 25 I 

It is soluble in water and alcohol. Being cheaper than citric acid, 
it may be used as a substitute for that acid. It is employed in 
making Seidlitz powders. Tartaric acid yields a precipitate (cream 
of tartar) with a solution of carbonate or other neutral salt of 
potassium, while citric acid yields none. 



ORDER VIII. SPINANTS. 

Under the term Spinants, or Spastics, are comprised medicines 
which are employed to excite muscular contraction, or whose 
ultimate effect is the production of motor paralysis, and may, 
accordingly, be divided into excito-motors and depresso-motors. 
Of the first class, the most important articles are vegetable sub- 
stances containing the alkaloids strychnine and brucine, which 
are employed therapeutically in torpid or paralytic conditions of 
the muscular system ; ergot, which is used to excite muscular 
contraction of the uterus ; and digitalis, which is given for its 
tonic effect on the heart. The latter class contains such remedies 
as conium, physostigma, woorara, etc. 

EXCITO-MOTORS. 
NUX VOMICA. 

Strychnos Nux vomica, or Poison-Nut (Nat. Ord. Logania- 
ceae), is a middling-sized tree of the coast of Coromandel and 
other parts of India, which bears a round, smooth berry, the size 
of a pretty large apple, of a rich orange color, and containing 
numerous seed imbedded in a juicy pulp. The seed are the 
officinal portion ; but the bark also is poisonous, and is known 
as false angustura bark, from its having been confounded with 
angustura bark. The seed are round, peltate, less than an inch 
in diameter, nearly flat, or convex on one side and concave on 
the other, and surrounded by a narrow annular stria. They 
have two coats : a simple fibrous outer coat, covered with short, 
silky hairs, of a gray or yellowish color, and a very thin inner 
coat which envelops the nucleus or kernel. This is hard, horny, 
of a whitish or yellowish color, and of very difficult pulveri- 
zation. The seed have no odor, but an intensely bitter taste, 
which is stronger in the kernel than in the investing membrane. 
They impart their virtues to water, but more readily to diluted 



252 MATERIA MEDIC A NEUROTICS. 

alcohol, and contain two active alkaloids, strychnine (officinal) and 
brucine, both of which exist in combination with an acid called 
igasuric ; another alkaloid, termed igasurine, much more soluble 
in water than the two first named, has been lately extracted from 
nux vomica. 

Strychnina {Strychnine) (CsiH^NsOa) is obtained by the fol- 
lowing process : Nux vomica is digested and boiled in water 
acidulated with hydrochloric acid, and the resulting strychnine 
and brucine hydrochlorate is decomposed by milk of lime. The 
strychnine is separated from brucine and impurities by boiling 
alcohol, from which it is deposited when cool, the brucine being 
left in solution. It is then converted into a sulphate by the addi- 
tion of diluted sulphuric acid, next decolorized by purified ani- 
mal charcoal, and again precipitated by solution of ammonia. 



Fig. 18. 




STRYCHNOS NUX VOMICA. A, B. SEEDS. 

Thus obtained, it occurs as a white or grayish-white powder (but 
may be made to crystallize in the form of white, brilliant rhombic 
prisms), of an intensely bitter taste, almost insoluble in water, 
slightly soluble in cold alcohol, but readily soluble in boiling 
alcohol. A very delicate test for strychnine is the potassium 
bichromate, which, added to a solution of strychnine in concen- 
trated sulphuric acid, produces a violet color, which after a time 
changes to wine-red, and then to reddish-yellow. Lead bin- 
oxide, manganese peroxide, potassium ferrocyanide and per- 
manganate act in the same way. In these tests the reagent is 
nascent oxygen. The presence of morphine in excess, of certain 
undefined organic substances,* and of curare, may disguise the 

* " Micro-Chemistry of Poisons," 1885, p. 569. 



SP1NANTS NUX VOMICA. 253 

color test ; here an alkaline mixture of chloroform should be-used 
to separate the strychnine from morphine ; while curare can be 
distinguished by its amorphous state. The physiological test 
should be always resorted to : if a small frog be placed in an 
ounce of water containing yj-g- of a grain of strychnine salt, in 
two or three hours it will undergo tetanic spasms, and soon die. 

Brucine (C^H^^O^ unofficinal) resembles strychnine in its 
action (Mays*). It differs from it in being locally analgesic and 
often destroying life without a trace of spasm. In the case of an 
adult f gr. ij induced convulsions which were counteracted by 
chloral. The dose is gr. \-\. 

PJiysiological Effects. — Nux vomica or its alkaloid, strychnine, 
increases the reflex excitability of the spinal cord, and thus pro- 
duces convulsions. Its action seems to be especially directed to 
excitation of the spinal motor centres. Klapp % affirms that even 
lethal quantities in the frog have no action on the sensory or 
motor nerve-endings, nor upon their trunks. This statement, 
however, is denied by Vulpian § and others. After death, galvan- 
ization of the motor trunks causes little or no contraction in 
response, due to direct action on, and exhaustion of the motor 
trunks. It stimulates the vaso-motor centres of the brain and 
spinal cord (Ott), and also the respiratory centre. Large doses 
paralyze these centres at once (Klapp), but the vagi are not affected 
either in warm- or cold-blooded animals. Death is due to as- 
phyxia. In very small and repeated doses, it has a tonic and 
diuretic effect, and sometimes operates slightly on the bowels 
and skin, but has no effect on the circulation. In somewhat 
larger doses, the stomach is often disturbed, the cardiac action is 
accelerated from stimulation of the cardiac ganglia, the visual 
sense is rendered more acute and the retina becomes hyperaemic, 
and in still larger doses, the muscular system becomes disordered. 
A sense of weight and weakness in the limbs, and increased sen- 
sibility to external impressions of all kinds, manifest themselves, 

* Pamphlet, " The Differential Action of Brucine and of Strychnine," Phila., March 
1887. • I Med. and Surg. Reporter, 1882, 194. 

% The Journ. of Ment. and Nerv. Dis., Oct. 1878, p. 619. " Physiological Action 
of Strychnine on the Brain, Spinal Cord and Nerves." 

\ Arch, de Physiologie Norm, et Path., hi, 1870, 116. " Remarques touchant 
Taction de la strychnine sur les grenouilles." 



254 MATERIA MEDICA NEUROTICS. 

with depression of spirits and anxiety ; the limbs tremble, and 
slight convulsive movements of the muscles appear. If the medi- 
cine be continued, or if a toxic dose be taken, convulsive parox- 
ysms of the whole muscular system ensue, with erotic desires, 
painful sensations in the skin, and occasionally eruptions ; the 
heart is slowed, and the blood pressure increased, probably 
through vaso-motor spasm. In paralytic patients the effects of 
the medicine are principally observed in the paralyzed parts. 
When taken in excessive doses the symptoms usually come on 
suddenly, and within half an hour, and consist of paroxysms 
commencing with a sudden shuddering, quickly passing into a 
tetanic convulsion of all the voluntary muscles. The body is 
bent backward until the occiput and heels support its weight 
(opisthotonus), the corners of the mouth are drawn up in a ghastly 
grin(risus sa7'donicus), and the face, at first pale, becomes livid as the 
paroxysm continues, from interference with respiration. Trismus 
(an early symptom in tetanus) occurs finally in severe cases. 

After a variable time the muscles relax and an interval of quiet 
succeeds, during which there is sometimes a slight rigidity of 
the muscles, but no marked stiffness as in tetanus. As a rule 
the paroxysms are painful. If the dose has been sufficient to 
cause death, the paroxysms rapidly succeed one another, in- 
creasing progressively in severity and duration until death occurs 
from fixation of the muscles of respiration, the intellect being 
usually unaffected up to the fatal termination. The convulsions 
resulting from the use of strychnine are of spinal origin, and are 
due to an exaltation of the reflex functions together with a stimu- 
lation of the motor cells of the cord. The reflex centres are in 
such an irritable condition that the slightest irritation of the sur- 
face, as by a breath of air, will produce a convulsion. There is 
no chemical antidote, unless, perhaps, tannic acid and the iodu- 
retted potassium iodide. The patient should be kept perfectly 
quiet and all sources of irritation, as draughts or loud noises, 
should be excluded, as likely to cause a tetanic paroxysm. The 
stomach should be emptied and the physiological antidote given. 
Chloral is the best physiological antidote. It* acts chiefly by 
lowering the activity of the parts which conduct the excitation 

* Schmidt's Jahrb., June, 1881, quoted by Am. J. M. Set., April, 1882. 



SPINANTS NUX VOMICA. 255 

to the spinal cord, preventing the too frequent repetition of the 
tetanic spasms and lessening their intensity. In grave cases arti- 
ficial respiration should also be resorted to. Some relief is 
afforded by holding the limbs or even by applying friction to 
them, during the paroxysm. The antidotism between strych- 
nine and chloral is not reciprocal. Opium, conium, ether, chloro- 
form, Calabar bean or potassium bromide, may also be exhibited 
as physiological antidotes. Paraldehyd is recommended by Cer- 
vello as a physiological antagonist. The action is not reciprocal 
(vide p. 86). According to Bignon,* cocaine will save the life of 
a dog poisoned by strychnia by maintaining cerebral excitement 
until the poison is eliminated. Recently Prof. Anrepf has called 
attention to urethan as a physiological antidote to strychnia 
and other tetanizers. Dr. Kratter announces that strychnine is 
excreted entirely unaltered by the urine, the excretion beginning 
within one hour and ending within forty-eight hours after admin- 
istration. The entire amount taken can be demonstrated in the 
urine J. 

Fatal Quantity. — The poisonous dose varies considerably, for a 
case§ is reported (that of Dr. Warner) in which gr. x / 2 killed an 
adult in twenty minutes, while recovery followed in a soldier || 
who had eaten about gr. xv. 

Medicinal Uses. — This medicine is our chief resource in torpid 
or paralytic conditions of the motor or sensitive nerves, or of the 
muscular fibre. When, however, paralysis is the result of inflam- 
mation of the nervous centres, it is injurious, and accelerates 
organic changes. It is most beneficial in those forms of paralysis 
which are independent of structural lesion, as lead palsy or pa- 
ralysis from drunkenness. In paralysis arising from cerebral 
hemorrhage — after the absorption of the effused blood, when the 
paralysis remains, as it were, from habit — the cautious employ- 
ment of nux vomica is often attended with advantage. In amau- 
rosis, free from cerebral complication, especially when due to 
alcohol or tobacco, it is very useful. In these cases strychnine 

* Bull. Gen. de Therap., CVII, p. 397, 1884. 
f Bull. Gen. de Therap., Feb. 15th, 1887. Quoted. 

\ Sep. Abd. Wien. Med. Wocken., 8, 9, 60, 82 ; quoted in Med. and Surg. Re- 
porter, Phila., Nov. 1 8th, 1882. $ Guy's Hosp. Reports, xi, p. 296. 
|| Medico-Legal Journal, Parker, 1885, p. 375. 



256 MATERIA MEDICA NEUROTICS. 

is recommended in doses of gr. -^ injected into the correspond- 
ing temporal region. It should be administered daily, and the 
dose increased until slight twitchings of the muscles are produced. 
In atrophy of the optic nerve-fibres, it has not met with the suc- 
cess which was predicted, but is of undoubted use before the 
stage of atrophy is reached. It has also been found very bene- 
ficial in chronic constipation, either alone or as an adjunct to 
cathartics : 1^ Resinae podophylli, gr. iij ; extracti colocynthidis 
compositi, gr. xij ; extracti nucis vomicae, gr. vj ; extracti hyoscy- 
ami, gr. xxiv. M. et ft. pil. xxiv. Sig. — Take one pill once, twice 
or three times a day, as necessary: ^ Aloin, gr. ij ; strych- 
nine sulphatis, gr. y^ ; extracti belladonnas alcoholici, gr. j. M. 
et ft. pil. xxiv. Sig. — One pill after each meal, three times a day. 
In dysentery, cholera, diarrhoea, impotence, incontinence of urine, 
spermatorrhoea, and other affections depending on functional 
atony and relaxation of muscular fibres ; in chorea and in epi- 
lepsy it is highly recommended ; in dyspnoea due to chronic 
bronchitis, dilated bronchi, emphysema, or incipient phthisis, it 
is of value as a respiratory stimulant ; it may be advantageously 
combined with digitalis when dyspnoea is due to cardiac disease, 
acting not only as a respiratory, but also as a cardiac stimu- 
lant; and in pure cardiac dilation it is well to alternate strych- 
nine (gr. g 1 ^-) with digitalis, giving either for a week or two at a 
time ; in combination with other remedies, as iron, in anaemia and 
chlorosis : 3^ Strychninae sulphatis, gr. %-% ', tincturae ferri 
chloridi, f5ij-iv ; acidi acetici diluti, f5j ; liquoris ammonii acetatis, 
f§iij ; elixir aurantii, q. s. f§vj. M. et S. — Two teaspoonfuls, largely 
diluted, three times a day, after meals. 3^ Ferri sulphatis exsic- 
cati, quininae sulphatis aa gr. xl ; strychninae sulphatis, gr. ss., 
mannae q. s. M. ft. pil. xx. S. — One t. d. In small doses it 
has been used with excellent effect as a general tonic where 
there is loss of nerve power, and as a stomachic in dyspepsia, and 
to relieve the vomiting of pregnancy, for which purpose the tinc- 
ture maybe given in ^J^—j doses, repeated several times at 
intervals of half an hour. 

In the treatment of the symptoms induced by the excessive 
indulgence in alcohol, Dobrowravow* reports good results from 

* Bull. Gin. de Thirap., Dec. 15th, 1887, quoted. 



SPINANTS IGNATIA. 257 

the hypodermic injection of strychnia, his observations extending 
over forty cases. 

Administration. — Dose of the powder, gr. ij or iij, in pill, several 
times a day, and increased till an effect is produced ; of the 
abstract, gr. ss-ij ; of the extract (alcoholic), gr. ss-j, to be repeated 
and increased ; of the fluid extract, ^j-v ; of the tincture, gtt. v 
to xx, and this is sometimes used as an embrocation to paralyzed 
parts. A tolerance of nux vomica and strychnine is rapidly 
established in the system. 

Strychnina {Strychnine). The preparation and tests for this 
alkaloid have already been considered (vide p. 252). 

The effects of strychnine are similar to those of nux vomica but 
more violent ; its local action is that of an irritant. It is employed 
for the same purposes as nux vomica, and should be given in 
very minute doses, as gr. 32 -" iV to De gm with, to be gradually 
increased, carefully watching the patient and suspending its 
administration as soon as twitching of the muscles, or an approach 
to the risus sardonicus, is observed. The salts of strychnine may 
be also employed in the same doses, but as they are more soluble 
than the alkaloid, they are more active. For endermic use, gr. 
^-q of the alkaloid may be used ; it is best used in amaurosis 
hypodermically, dose, gr. -^ to begin with. The salts are pre- 
ferred for hypodermic use, because of their greater solubility. 

Strychnine Sulphas (Strychnine Sulphate) is made by dis- 
solving a mixture of strychnine in distilled water, with diluted 
sulphuric acid, and evaporating. It occurs as a white salt, in 
colorless, prismatic crystals, efflorescent, odorless, very bitter, 
readily soluble in water, sparingly soluble in alcohol, and insolu- 
ble in ether. It responds to the tests for strychnine, and may be 
used for the same purposes and in the same doses. 

IGNATIA. 

The seed of Strychnos Ignatii, or St. Ignatius' Bean (Nat Ord. 
Loganiaceae), a tree of the Philippine Islands, contains a large 
proportion of strychnme, some brucine, etc., and possesses medi- 
cinal properties analogous to those of nux vomica. It may be 
given to fulfill the same remedial indications as nux vomica. An 
abstract (dose, gr. %-]) and a tincture (dose, ^v-xx) are offi- 
cinal. 

17 



258 MATERIA MEDICA NEUROTICS. 

HYDRASTIS. 

The rhizome and rootlets of Hydrastis canadensis, Yellow 
Root or Golden Seal {Nat. Ord. Ranunculacese), a small indi- 
genous plant, with yellow, fugacious flowers, and a red fruit 
resembling raspberries, has from recent experiments been classed 
among the excito-motors. It contains the alkaloids hydrastine 
(C 2l H 21 N0 6 ), berberine (C2oH 17 N0 4 ), and xanthopuccine* , which is 
simply impure berberine; also starch, sugar ; etc. (Maisch). 

Physiological Effects. — According to A. J. Slavatinski,f when 
hydrastine is given hypodermically to frogs in small doses 
(.001-002 gm.) it causes incoordination of movements, general 
sluggishness and weakness, quickened respiration, and a reduc- 
tion of the cardiac frequency from J— J of the normal rate, and at 
the same time the individual contractions are very energetic. 
When a larger dose (.003-005 gm.) is given, general convul- 
sions occur (resembling those caused by strychnine), which 
disappear on section of the spinal cord. The effects on the 
heart are intensified, and the cardiac action is interrupted by 
diastolic arrests. If a still larger amount (.005-01 gm.) be 
given, the convulsions are followed by prostration, paralysis 
and death, the heart stopping in diastole. When placed on the 
cut-out heart, the cardiac action stopped and the heart could not 
be made to respond to further irritation. It probably acts on 
the heart not only through the par vagum, but also through the 
cardiac ganglia, and in large doses, paralyzes the cardiac muscle 
directly. It stimulates the reflex centres of the cord, exalts the 
irritability of the motor nerves, and probably depresses the end- 
organs of the sensory nerves. Given to warm-blooded animals 
it slows the cardiac action, causes general depression, dis-coordi- 
nation and incessant tremor ; large doses cause death, which is 
due to tetanus of the respiratory muscles, and is preceded by 
general paralysis. The action of hydrastis is less powerful but 
of longer duration than that of strychnine, which it resembles. 
It acts, also, as a diuretic, and according to Rutherford, it is a 
hepatic stimulant of considerable power, and a feeble intestinal 



* Proc. Amer. Pharm. Associat., 1884, p. 456; F. B. Power. 

f Meditz Obozr., No. 16, 1884, p. 346; quoted by Lond. Med. Pec, Nov. 15th, 
:88 4 , p. 498- 



SPINANTS COCCULUS INDICUS. 259 

stimulant. According to Givopiszew* hydrastis always provokes 
uterine contractions, which are less intense than those of ergot. 

Medicinal Uses. — It is recommended as a nerve tonic and anti- 
fermentative in atonic dyspepsia and chronic gastritis. From its 
action on the liver and intestines it is useful in duodenal catarrh, 
catarrhal jaundice, and constipation due to deficient secretion. 
It is an efficient diuretic, and has been used for this purpose in 
promoting the discharge of calculi from the kidneys. It is also 
used in chronic cystitis, and has been employed internally and 
by injection for the cure of gonorrhoea, in the stages of decline, 
and in gleet, and also as an injection in uterine and vaginal 
leucorrhceas. It is an excellent remedy against uterine hemor- 
rhage due to inflammation of the organ, coincident with the 
menopause or too abundant flow at the monthly period. (Givo- 
piszew, loc. cit.) 

From the study of its effects, it should be useful in the same 
class of cases in which strychnine is employed. 

Dose, of the fluid extract, f5j-iv; as a stomachic tonic, 
t^v-xv before meals. The tincture may be given in doses of 
r^x-foj, t d. 

As an injection in gonorrhoea, hydrastine may be used in the 
strength of gr. x-xv to mucilage f§»j. % 

Rhus Toxicodendron {Poison- Oak). The fresh leaves of 
Rhus toxicodendron, or Poison-Oak {Nat. Ord. Terebinthaceae), 
an indigenous shrub from one to three feet high, and other 
species of Rhus, possess properties somewhat analogous to those 
of nux vomica, and have been employed with success in paraly- 
sis. They contain toxicodendric acid y to which their poisonous 
and medicinal activity is due. Dose, gr. j-iij, or more, to be 
repeated and increased. In cases of poisoning, the irritation of 
the skin is relieved by glycerite of carbolic acid or alkaline 
solutions. 

COCCULUS INDICUS. 

Cocculus Indicus (not officinal) is the dried seed of Anamirta 
paniculata {Nat. Ord. Menispermaceae), a climbing shrub of 
India. The fruit is a one-celled berry, of a dark purplish color, 

* These, St. Petersburg, 1887, quoted by Bull. Gen. de Therap., cxiv, 189. 



260 MATERIA MEDICA — NEUROTICS. 

with a soft pulp, and a single seed the size of a pea, containing a 
bitter kernel. The active properties reside in a peculiar white, 
crystallizable bitter principle which is officinal under the name 
of picrotoxinum (picrotoxin, C 9 H 10 O 4 ). It is partially soluble in 
water, and very soluble in alcohol, chloroform and ether. Pic- 
rotoxin is not precipitated by the reagents for the alkaloids, and 
does not neutralize acids. In the shell, an alkaloid termed 
menisp ermine has been found, and a neutral principle of the same 
composition as the alkaloid, termed paramenispermin. 

Effects and Uses. — Picrotoxin is an acrid cerebro-spinal narcotic, 
capable, in large doses, of producing death by tetanic fixation 
of the respiratory muscles. Its cerebral effects are variously 
described, such as stupor, giddiness and vertigo. In doses suffi- 
cient to produce these effects it is apt to nauseate. It is a tetaniz- 
ing agent, the tetanus being followed by convulsions, paralysis 
and coma. According to Chirone * the chief action of the drug 
appears to be that of an excitant of the centres located in the 
medulla oblongata and spinal cord. The convulsions can be 
brought on in an animal from which the brain has been removed. 
Picrotoxin is capable of originating an artificial epilepsy, and it 
acts independently of the psycho-motor centres, its influence 
being most decided when they are removed. During the con- 
clusive stage the heart's action increases, while in the stage of 
coma it becomes slow, and after death it is found to be in dias- 
tole. Picrotoxin induces decided diaphoresis. It has not been 
much used internally, except in the night sweats of phthisis, for 
which Murrell recommends it, in doses of gr. yJtt to To> kut m 
the form of decoction or ointment it is employed to destroy lice 
and other parasites, and for the cure of tinea and porrigo of the 
scalp. It is said to prevent the secondary fermentation of malt 
liquors, into which it is sometimes introduced as an adulteration. 

ERGOTA ERGOT. 

Ergot is a fungus growing from the diseased ovary of Secale 
cereale, or Rye (Nat. Ord. Graminaceae). The U. S. Pharma- 
copoeia styles it the Sclerotium of Claviceps Purpurea (Nat. 



* Annali Univer. di Med. le Ckirurgia, vol. 251, 1 880, p. 289. Ricerche speri- 
mentali sulFazione biologica della picrotoxina; pel V. Chirone. 



SPINANTS — ERGOT. 26 1 

Ord. Fungi), replacing the grain of Secale cereale. In the, pro- 
duction of ergot there are three stages, as follows: 1st, in the 
flowering season one or more ovaries in an ear of rye are covered 
by a sweet yellowish mucus — the honey dew of rye — which con- 
tains numerous microscopic cells called conidia, a sugar, and is 
the product of the decomposition of the constituents of the ovary 
caused by the developing mycelium of the fungus. This is formed 
of filamentous cells termed hyphcB, and the first stage ends when 
the hyphae have penetrated the ovary and separation of the conidia 
have ceased. 2d, when the hyphse unite at the base of the ovary 
into a purplish-black body (ergot) extending to the apex of the 
grain. 3d, the development of the fungus is completed. It will 
be seen that ergot is the dormant or intermediate stage of a fungus 
called Sclerotium, compound mycelium or spawn. Its predis- 
posing cause is unknown, and it is not peculiar to rye, many 
other grasses being subject to it, as abortion in grazing animals 
has been frequently produced by their eating grasses affected 
with ergot. The ergot usually projects out of the glum or husk 
of the plant, beyond the ordinary outline of the spike or ear. It 
should not be collected until some days after it has begun to 
form, as it is thought not to possess full activity until about the 
sixth day of its formation. As found in the shops it consists of 
cylindrical or somewhat prismatical tapering grains, curved like 
the spur of a cock, of a purplish color externally, and of a yellow- 
ish or grayish-white color within. Its smell is peculiar and 
nauseous ; its taste is at first faint, but becomes bitterish, acrid 
and disagreeable. It yields its virtues to water and alcohol, and 
does not keep well, being liable to the attacks of a minute worm. 
It deteriorates much more rapidly in powder than when in grain, 
in the former condition soon becoming inert. 

Numerous analyses have been made of ergot, but there is still 
some uncertainty as regards its active principles, though this is 
gradually growing less. The investigations of Dragendorff seem 
to show that the specific effects of the drug depend in a high 
degree upon a proximate principle of an acid character, to which 
the name of sclerotic acid is given. It is odorless and tasteless, 
soluble in water and boiling alcohol, but not at all in cold 
alcohol. Good ergot contains about 4 to 4.5 per cent, of the acid. 
The most reliable investigations upon this question are those of 



262 



MATERIA MEDICA NEUROTICS. 



Kobert,* which point to the following conclusions : viz., that ergot 
does not owe its ecbolic power to ergotinic acid, which has no 



Fig. 19. 




SECALE CEREALE. A, A. ERGOT. 



influence on the uterus, but that spliacelinic acid, a resinous body 
insoluble in water, never failed to produce powerful contractions 



* The Practitioner, Dec, 1885, p. 414; and Arch, fur Exp. Pathol, u. Phar- 
makol., 1884, XVII, p. 316. 



SPINANTS ERGOT. 263 

in the gravid uterus, while cormitin, gr. y$, either in the pregnant 
or non-pregnant uterus, likewise exhibited the same action. Ac- 
cording to this observer, the only active preparation is one con- 
taining both cornutin and sphacelinic acid, and, finally, that no 
sample of ergot, either European or American, retained its virtues 
for more than 12 months. Ergot also contains scleromucin (2 to 3 
per cent.), sclererytherin, scleroiodin, picrosclerotin (poisonous), 
sclerocryslallin, and scleroxanthin (inert), and an alkaloid, ergo- 
tinine (Maisch). 

Physiological Effects. — The effects of ergot are not well under- 
stood, especially as regards its action on the nervous system. In 
medicinal doses it acts most conspicuously on the circulation and 
on the female system, in which it excites powerful contractions 
of the uterus. After labor has commenced, in ten or twenty min- 
utes from its administration, it increases the violence, frequency 
and continuance of labor pains, which usually never cease until 
the child is born. Administered before labor, it frequently origi- 
nates the process, though its effects in this respect are less con- 
stant. And even in the unimpregnated uterus it produces painful 
contractions, and evinces an influence over morbid conditions of 
the organ by checking uterine hemorrhage and expelling polypi. 
Ergot induces * contraction of the unstriped muscular fibre 
wherever found, causing a shrinkage in the caliber of the blood- 
vessels everywhere, and it is thus available generally as a remedy 
in cerebral and spinal congestions, hemorrhages, tumors, morbid 
growths and enlargements. In large doses it produces vomiting, 
purging, increased peristalsis, and a marked sedative f effect on 
the circulation, slowing the heart (10-36 beats), probably by 
direct action on the cardiac muscle, and causing an enormous 
rise in the blood pressure, through the contraction of the arte- 
rioles and stimulation of the vaso-motor centres of the cord and 
medulla ; decided toxic doses lower the blood-pressure, by 
depressing the heart and vaso-motor centres (Brown-Sequard). 
In excessive quantities it acts as an acro-narcotic poison on both 
sexes. When it is used for a length of time as an article of food 

* Arch, de Physiol. Norm, et Pathol., in, 1870, p. 584. Effets de 1' extraitd' ergot 
sur la pression arterielle ; par Ch. L. Holmes. 

| Bull. Gen de Therap., lxxviii, pp. 433, 481. Ergot, ergotine, action physiol., etc. 
M. Bailley. 



264 MATERIA MEDICA NEUROTICS. 

it produces a peculiar morbid condition, termed ergotism, which 
assumes two forms, one attended with convulsions, the other 
with dry gangrene of the limbs. 

Medicinal Uses. — From its action on the pregnant uterus, ergot 
has long been used in obstetric practice. With few exceptions 
ergot had better not be administered while any product of con- 
ception remains within the uterine cavity, because, while causing 
contraction of the muscular fibres of the fundus, which would 
produce expulsion of the uterine contents, it also causes con- 
traction of the sphincter-like fibres of the cervix, and thus pre- 
sents an obstacle to the emptying of the uterus. As the 
intermittent contractions of the uterus become continuous and 
tetanic under the influence of a large dose of ergot, it is obvious 
that rupture of the uterus may occur if the resistance offered to 
the expulsion of the uterine contents be sufficiently great. Partly 
on this account, and partly because the tetanic contraction of the 
uterus induced by ergot would interfere with the circulation of 
the fcetus, it should never be administered during the first stage 
of labor. During the second stage of labor, it may be given if 
the expulsive pains are feeble and inefficient (uterine inertia), 
when there is a proper conformation of the pelvis and soft parts , 
when the os uteri, vagina, and os externum are dilated or readily 
dilatable, and when the presentation of the child is such as to offer 
no great mechanical impediment to speedy delivery. In these cases 
it is best to administer it in small doses (^viij— x of the fluid 
extract), as when thus given it simply intensifies the natural ute- 
rine contractions without causing them to become continuous. 
It has also been used in the second stage of labor in women sub- 
ject to flooding, given just before delivery, but even in these cases 
it is better to withhold the drug until the placenta is expelled, 
as otherwise the uniform contraction induced may lead to its 
retention. 

After the third stage of labor is completed, if hemorrhage is 
likely to occur from uterine inertia, ergot is one of the best 
remedies we possess, as the tetanic contractions which it pro- 
duces permanently arrest the bleeding by compressing the 
orifices of the vessels. It has been used in the hemorrhage due 
to abortion, but as the bleeding will only stop when the uterine 
cavity is empty, and as ergot delays this by preventing dilata- 



SPINANTS ERGOT. 265 

tion of the cervix, the tampon and other means are preferable. 
When, after an abortion, the placenta is retained by adhesions so 
firm that it is impossible to destroy them, a tampon may be 
employed and ergot given simultaneously. Ergot has also been 
used to cause the expulsion of polypi, and even of interstitial 
fibroids from the uterus. In speaking of its administration in the 
latter class of tumors, Emmet* says : " It should never be given 
in large doses until after the uterine canal has been dilated, and 
until it is found that the tumor projects sufficiently to warrant 
the belief that it may become pedunculated by uterine contrac- 
tion." By neglecting these precautions he has seen peritonitis 
produced. It is best to administer it hypodermically in these 
cases. In subinvolution, especially when menorrhagia is present, 
ergot combined with potassium bromide is useful. From its action 
on unstriped muscular fibres it is much employed in hemor- 
rhage generally; in gonorrhoea; congestive dysmenorrhcea ; 
paralysis of the bladder, especially when due to over-distention ; 
purpura ; diabetes insipidus ; and lately, with marked success, in 
hypertrophy of the prostate ; by hypodermic injection, in the 
cure of aneurism and varix, and as a means of checking broncho- 
pulmonary hemorrhage. It is also used in renal, intestinal, and 
uterine hemorrhage. In hematemesis it may also be employed, 
but is inferior to other remedies. In paralysis dependent upon 
congestion of the spinal cord in spinal meningitis, and in acute 
myelitis, it is often of great service. Ergot exercises a dangerous 
sedative influence on the child during labor (owing to the inter- 
ference of the passage of blood from the placenta during violent 
uterine contraction), and its use may sometimes produce foetal 
death, if the obstetrician is not careful to listen frequently to the 
foetal heart, and deliver with the forceps should any sign of 
asphyxia be present (Spiegelberg). 

Administration. — Ergot may be given in labor, in the dose of 
gr. v-xx, in powder, every twenty minutes, till its effects are 
produced, or three doses are taken : in other diseases the dose is 
from gr. iij-x. It may be safely given, in chronic diseases, for a 
long period, without danger of ergotism ; the indication of the 
maximum dose having been reached in the female is the produc- 

* " Princip. and Practice of Gynaecol.," 3d ed., p. 567. 



266 MATERIA MEDICA NEUROTICS. 

tion of uterine colic, when the quantity should be diminished. The 
fluid extract is the best preparation ; dose, ^v-f5j or more.* The 
extract is made by evaporation of 500 parts of fluid extract over 
a water-bath at a temperature not exceeding 122 F. until it is 
reduced to 100 parts; dose, gr. v-xv. The wine (vinum ergotce) 
contains powdered ergot, 15 parts, in 100 parts by weight of the 
preparation. Dose, foj-iv. The preparations used under the 
name of ergotin are of uncertain strength. 

USTILAGO. 

Ustilago maydis {Nat. Ord. Fungi), Corn Smut or Corn Ergot, 
is a fungoid growth upon the Zea Mays or Indian Corn (Nat. 
Ord. Graminaceae). It has been known to exist for more than 
one hundred years, having bden described by Pujol f in the last 
century. It is found in irregular masses in the Northern States, J 
during the middle and latter part of summer, growing most fre- 
quently upon the young ears and tassels, the leaves being usually 
exempt, and consisting of a blackish gelatinous membrane, 
inclosing numerous dark globular and nodular spores, which 
break up like a great puff-ball, discharging a cloud of brownish 
impalpable dust of narcotic odor. It has a disagreeable odor 
and taste, and contains a fixed oil, probably sclerotic acid, a. crys- 
talline principle \ etc. (Maisch). 

J. Mitchell § has investigated its action upon frogs with the 
following results : By injection it induces tremors and clonic 
spasms ; increased doses cause irregular respiration, weakened 
muscular movements, spasms, palsy and death, the latter due 
to paralysis of respiration ; the heart continues to beat after life 
is apparently extinct. Lethal amounts abolish all movements, 
suspend reflex action, and contract the pupils. The suspension 
of reflex action is due to paralysis of the sensory part of the 
cord ; the motor tracts, too, being depressed. We have seen no 



* For hypodermic use, the fluid extract should be reduced by evaporation to one- 
sixth of its weight, and sixty grains of this extract should be dissolved in four flui- 
drachms of water ; four minims of this aqueous solution represent one grain of extract 
and six grains of ergot; or the fluid extract may be carefully filtered, and used in 
doses of rr^x ; or the extract may be dissolved in water and filtered ; it is five times 
as strong as the fluid extract. f Journ. de Medecine, 1774, I, p. H5« 

% Therap. Gaz., 1881, p. 121. Prof. Spalding. \ Ibidem, 1886, p. 223. 



SPINANTS BARK OF COTTON ROOT. 267 

statement of its action on muscular fibre of either kind, though 
Dr. Steel* noticed that cows when turned into fields to feed 
aborted unless the corn smut had been removed, which indicates 
an action of contraction upon the muscular structure of the 
uterus. 

Its effects resemble those of ergot, and it has been successfully 
used in the same class of cases. (Midwifery — Drs. Vernon f 
and RouseJ.) Dose of the fluid extract (unofficinal), gtt. x-xx. 

GOSSYPII RADICIS CORTEX BARK OF COTTON ROOT. 

Gossypium herbaceum (Nat. Ord. Malvaceae) is a native of 
Asia, cultivated extensively in tropical and semi-tropical coun- 
tries, and with great success in the South Atlantic and Gulf 
districts of the United States. By cultivation, different varieties 
of this plant have been produced. The root should be collected 
immediately after the cotton is harvested, and the root-bark 
should be of a yellowish-brown color externally, internally much 
lighter ; when chewed, it has a slightly sweetish, astringent taste. 
It contains cliromogene (when fresh), becoming a red resin, a 
yellow resinous coloring matter, fixed oil, gum, sugar, tannic acid, 
etc. It has long been recognized by southern physicians as 
possessing decided influence in exciting uterine contractions. Dr. 
J. C. Martin,§ from experiments on frogs, rabbits, and guinea-pigs, 
concludes that it has no action on the motor or sensory nerves, 
nor on the reflex functions ; that the circulation and muscles are 
uninfluenced by it, and that it possesses no oxytocic properties. 

The most recent investigations, however, show that in large 
doses it kills by paralysis of respiration, often preceded by clonic 
convulsions not prevented by section of the cord ; the reflex 
centres of the cord are depressed, but the motor and sensory 
nerves are not affected. The blood-pressure falls, from depression 
or paralysis of the vaso-motor centres, this fall being preceded 
by a rise in pressure if the dose be small. In large amounts it 
causes great venous congestion and tension, stimulates and then 
paralyzes the cardio-inhibitory apparatus and depresses the 

* Trans. Wisconsin State Med. Society, 1878, p. 127. 

f Chicago Med. Times, II, 1879-80, p. 434. % Therap. Gaz., 1886, p. 163. 

§ Am. Journ. Med. Sciences, Jan., 1882. An investigation of the physiological 
effects of Gossypium herbaceum. 



268 MATERIA MEDICA NEUROTICS. 

cardio-motor ganglia, thus at first retarding and then accelerating 
the pulse, which is always weakened. The pupil is always dilated. 
It stimulates muscular action, especially that of the unstriated 
variety. It often causes vomiting and purging. In cats and 
rabbits, gossypium causes, in small and repeated doses, intermit- 
tent rhythmical contractions of the gravid uterus, leading to com-, 
plete expulsion of its contents, and it has been seen to increase 
the uterine contractions when administered after their inception.* 
Prochovnik finds it an efficient substitute for ergot, although its 
expulsive power is not so great. He recommends it especially 
in hemorrhage after abortion, and in uterine myoma. The only 
officinal preparation is the fluid extract (which, when first prepared, 
is of a brownish-yellow color, changing, however, to a bright red) ; 
dose, foss. Gossypium {Cottojt), the well-known filamentous sub- 
stance separated from the seed of the varieties of gossypium, is 
a useful application to burns and parts affected with erysipelas and 
rheumatism, and is much used as dressing in various surgical 
affections, and after operations. Impregnated with iodoform, it 
may be packed in the vagina as a tampon, in various hemor- 
rhages from the uterus (as in threatened abortion, etc.), or to give 
support and correct displacement in cases of version of the uterus. 
It is particularly adapted to those cases where, from inflamma- 
tion or tenderness of the parts, an ordinary pessary could not be 
worn. It is also impregnated with carbolic, salicylic, boric acid, 
or corrosive sublimate, for use as a surgical dressing. 

DIGITALIS. 

Digitalis purpurea, or Purple Foxglove {Nat. Ord. Scrophu- 
lariaceae), is a biennial European plant, cultivated in our gardens, 
with an erect stem three or four feet high, large ovate-lanceolate, 
crenate, downy and veiny leaves, of a dull green color, and 
handsome bell-shaped crimson or purple flowers, arranged in a 
large terminal spike. The seeds and leaves are both active, 
but the latter only are employed, from plants of the second year's 
growth; and those from the European wild plants are preferred, 
as the cultivated variety is thought to be inferior in virtue. The 

* " Gossypium Herbaceum." Thesis by Thos. Harry Huzza, M.D., awarded the 
Medical News Prize at the Jefferson Medical College, of Philadelphia, 1887. 



SPINANTS DIGITALIS. 



26q 



petioles are removed, and the leaves are then dried in baskets, in 
a dark place, in a drying-stove. When dried, they have a dull- 
green color, with a faint odor and a bitter, nauseous taste, and 
afford a fine deep-green powder. Both leaves and powder should 
be preserved in well-stoppered bottles, covered externally with 
dark-colored paper, and kept in a dark cupboard, and, as their 
medicinal activity is impaired by keeping, they should be renewed 
annually. They contain several glucosides termed digitalin, 
digitoxin, and digitalein, which possess properties similar to those 



Fig. 20. 




DIGITALIS PURPUREA. A, LEAF ; B, FLOWERS. 



of the leaves ; digitonin, which is said to resemble saponin, but 
which differs from it in its behavior to chemical reagents ; and 
also some inosit, pectin, resin, etc. Digitalin and digitoxin are 
the most active ingredients of the plant. 

Digitalin, when perfectly pure, occurs as fine, white, glittering 
hygroscopic needles, or groups of crystalline tufts, odorless, but 
of a very bitter taste ; readily soluble in alcohol, chloroform and 
warm acetic acid, but nearly insoluble in water and ether ; dose, 
from -^q to -^q of a grain. A dose above gr. -^ causes purging and 



270 MATERIA MEDICA NEUROTICS. 

vomiting. According to Woodman and Tidy about gr. y^ would 
prove fatal, and a toxic amount rarely kills in less than 24 hours. 
Physiological Effects. — Though the action of digitalis is directed 
chiefly to the circulatory apparatus, yet in lethal quantity other 
phenomena are induced, as follows. Nervous system : in toxic 
doses, digitalis lowers reflex activity by exciting Setschenow's 
inhibitory reflex centre, and, after a time, paralyzing the spinal 
cord (A. Weil), causing prostration, muscular tremors and some- 
times convulsions. Circulation — Its action here has been inves- 
tigated by Vulpian, Pelikan, Homolle,* Gaskell f and others, with 
the following results, viz. : that it lessens the number of cardiac 
pulsations, prolonging the diastole, energizing the systole ', and finally 
paralyzing the heart in systole ; this is produced by direct stimu- 
lation J of the cardiac muscle, and possibly of the contained motor 
ganglia, as well as of the peripheral inhibitory fibres of the pneu- 
mogastric. Moderate doses cause a rise in the arterial pressure, 
probably by contracting the arterioles, through stimulation of 
the vaso-motor centres of the cord; after large doses the pulse 
becomes dicrotic from irregular ventricular contraction ; toxic 
doses, or, when the heart is much depressed, a sudden change 
from the recumbent to the erect position, may cause a frequent, 
weak and small pulse, with lowered blood-pressure. An entirely 
satisfactory explanation of the modus operandi of digitalis on the 
circulatory apparatus has not so far been made. The influence 
of digitalis over the pulse is more,marked in weak and debilitated 
persons than in those who are robust and plethoric. Its effects, 
too, in this particular are more easily obtained in the recumbent 
than in the erect posture, owing to the less force required in the 
former position to carry on the circulation. In the repeated use 
of small doses of this medicine, a cumulative effect is sometimes 
observed : its powers are not manifested for a certain time, and 
effects are suddenly produced, which are attributable to the 
whole amount administered, giving rise to dangerous and even 

* Arch. Gen. de Medecine, XVIII, p. 5. Exper. physiol. sur quelques preparat. de 
digitale. 

f The Journ. of Physiology, III, p. 48. On the Tonicity of the Heart and Blood 
Vessels. 

% Proc. of the Royal Med. and Surg. Soc, 1, 1882-5. Investigations into the 
Action of the Digitalis Group. Ringer and Sainsbury. 



SPINANTS DIGITALIS. 2J\ 

fatal syncope. In morbid conditions of the circulation, where 
it is irritable, abnormally quick or irregular, digitalis is consid- 
ered to exercise a primary medicinal effect in steadying the pulse 
and restoring its force and regularity, while it diminishes morbid 
frequency. Where the temperature of the body is abnormally 
increased, digitalis, in large doses, will diminish it. From its 
action on unstriated muscular fibres, digitalis has the property 
of stimulating the uterus to contraction. As regards its diuretic 
action, it is probably rather indirect than direct, and is most 
conspicuous where dropsical effusions are removed under its 
influence. Brunton has, however, shown that in dropsies it acts 
directly on the Malpighian tufts, independent of the blood- 
pressure. It increases the amount of solids eliminated in the 
urine, except that of urea and uric acid, which are diminished 
under its use. When too long continued, or taken in excessive 
doses, digitalis acts as an acro-narcotic poison, producing vomit- 
ing, purging, irregular, feeble and rapid cardiac action, severe 
abdominal pains, vertigo, disordered vision, dilated pupils, syn- 
cope, and finally delirium and stupor, death being usually pre- 
ceded by convulsions. In such cases, after evacuating the 
stomach, the diffusible stimuli, as brandy and ammonium car- 
bonate, should be administered. Opium, aconite, etc., antagonize 
to some extent the action of digitalis; the most complete antago- 
nism exists between digitalis and saponin, the active principle of 
Saponaria officinalis (Kohler). The quantity of digitalis, how- 
ever, that may be given, especially in disease, without destroying 
life, is considerable. Chemical analysis affords no certain tests 
of the presence of digitalis or its active principle, even Grandeau's 
method of isolating digitalin by dialysis being uncertain, and in 
cases of suspected poisoning the physiological test must be resorted 
to. This, however, is not proof positive of its presence, for 
Fagge and Stevenson* have shown that digitalis is only one of 
a small class of substances (as helleborus viridis and scilla) the 
action of which on the frog's heart appears to be identical. 
These they termed cardiac poisons. In every experiment they 
caused cardiac irregularity, followed by stoppage of its pulsa- 



* Proc. Royal Society, xiv, p. 270. On the Application of Physiological Tests for 
Certain Organic Poisons, especially Digitaline. 



272 MATERIA MEDICA NEUROTICS. 

tions in rigid ventricidar contraction. In the celebrated Pomme- 
rais case, the criminal was condemned from the evidence derived 
from the administration of an extract obtained from the stomach 
and bowels of the deceased party, to small animals, in whom 
were produced vomiting and marked diminution of the number 
of heart-beats, with intermittent and irregular action. 

Medicinal Uses. — From its action on the circulation, digitalis 
has been used in adynamic fevers and inflammations, and in 
hemorrhages, especially in menorrhagia, metrorrhagia, and post- 
partum hemorrhages. In hectic fever, it is often combined with 
quinine, and if it do not disorder the digestion, it is generally 
of great value: 1^ Quininae sulphatis, gr. xxiv; pulveris 
digitalis, gr. viij ; pulveris opii, gr. yj. M. et ft. pil. xxiv. Sig. — 
Take one pill 3 or 4 times a day. In fevers accompanied by a 
high temperature, as scarlatina and typhoid fever, it is specially 
useful. In the treatment of diseases of the heart and great ves- 
sels, it is a remedy of the greatest value, but it is to be prescribed 
with discrimination. In dilatation of the heart, in fatty degenera- 
tion, and in irritability of heart-action generally, digitalis, by 
increasing the force of the cardiac contractions and by abating 
irregular movement, is always useful ; in uncomplicated hyper- 
trophy it is objectionable. In cases of sudden cardiac failure 
from any cause, a hypodermic injection of the tincture ig£x— xx, 
repeated, if necessary, in half an hour, may be advantageously 
administered. H. C. Wood states that he has never seen any 
severe local irritation follow this use of the tincture, which also 
accords with our observations in several cases (H. M.). In valv- 
ular, especially mitral, disease, as well as aortic constriction, if 
the heart's action be feeble, it is indicated. It is greatly esteemed 
in the treatment of dropsy ; and in the varieties of this disorder 
resulting from heart disease the infusion of digitalis is more 
employed than any other remedy, from its combined cardiac and 
diuretic influence. In these conditions it may often be advan- 
tageously combined with iron. 3^ Pulveris digitalis, gr. xv; 
ferri sulphatis exsiccati, gr. x; quininae sulphatis, gr. xx ; oleo- 
resinae capsici, gr. iij. M. et ft. pil. xx. Sig. — Take one pill three 
times a day ; or the infusion may be alternated with a mixture 
containing tincture of ferric chloride. It is a valuable remedy in 
acute desquamative nephritis, especially when dropsy is present, 



SPINANTS — ADONIDIN. 273 

and also in granular degeneration of the kidney under like cir- 
cumstances. In delirium tremens, digitalis has been given in 
large doses, with excellent effect. It is thought that a physio- 
logical antagonism exists between digitalin and the alkaloids 
aconitine, delphinine and muscarine. 

Administration. — Digitalis may be given in powder, of which 
the dose is gr. j two or three times a day, to be gradually 
increased. The officinal preparations are the abstract, dose, gr. 
ss-j ; the infusion (powdered digitalis and cinnamon each 3 parts, 
macerated in 185 parts of boiling water for 2 hours, then strained 
and 15 parts of alcohol passed through the strainer, and water 
enough to make 200 parts), dose, f3ij-iv; the tincture, dose, ^v- 
foj ; the extract (alcoholic), dose, gr. J^, gradually increased; the 
fluid extract, dose, *xj to begin with. If digitalis produce wake- 
fulness, a little opium may be combined with it. 

ADONIDIN. 

Adonidin (not officinal) is a glucoside, obtained from the root 
of Adonis vernalis (Nat. Ord. Ranunculacese), a plant of central 
Europe. It was first isolated by Cervello,* and is an amorphous 
substance, odorless, colorless, but having an intensely bitter 
taste, soluble in alcohol, but slightly soluble in ether and waterf. 

Effects and Uses.-— Adonidin is almost identical in action with 
digitalis^, strengthening the cardiac energy, while diminishing its 
frequency by prolonging the diastole, thus allowing the engorged 
veins time to empty themselves, and at the same time raising the 
arterial tension by contracting the arterioles. It acts more 
quickly on the heart than does digitalis, and is not so apt to dis- 
order the stomach and bowels (Cervello ; Durand), although 
these effects are sometimes observed. 

According to most authorities it possesses considerable diu- 
retic powers, increasing both the water and the solids of the 
urine. It is rapidly eliminated, and has no cumulative action 

* Archiv fur Experiment. Pathol, und Pharmakol., 1882, p. 338. 

f " Poisons; their Effects and Detection," by Alexander Wynter Blyth. Am. Ed., 
p. 396. 

X V. Cervello, op. cit. and La Mid. Contemp., July and Aug., 1885. E. Durand, 
Journ. de Med., Dec, 1885 and These de Paris, 1886. Bubnow, Centralbl. fur 
die gesammte Therapie, 1885. Houchard, Gaz. J/ebdo/nadaire, ]a.n. 1st, 1886. 
18 



274 MATERIA MEDICA NEUROTICS. 

(Cervello). According to Hare,* in all doses it increases the 
arterial tension by stimulating the vaso-motor centres and increas- 
ing the force of the cardiac contractions ; large doses slow the 
heart by stimulating the vagus, which finally becomes paralyzed, 
the pulse rate being then accelerated. 

Adonidin may be used for the same purposes as digitalis, 
to which, however, it is inferior. When the latter is contra- 
indicated from some idiosyncrasy on the part of the patient, or 
when it disorders the stomach, or if its action be not sufficiently 
rapid, adonidin may be substituted with advantage. It may, too, 
be alternated with digitalis, giving either for a few weeks at a 
time. Dose, gr. y&—yi in compressed pill or capsule. 

STROPHANTUS. 

Strophantus (not officinal) is the seed of the Strophantus his- 
pidus {Nat. Ord. Apocynaceae), a plant distributed along the 
coast of Africa, between Senegambia and Lower Guinea. It is 
described by Blondel f as a branchy bush growing to the height 
of three or four metres, which gives off yellowish-white flowers, 
appearing in April or May, arranged in terminal cymes. The 
seeds are contained in a thin cylindrical pod, the length of which 
varies between 25 and 50 centimetres. They are from 10 to 14 
millimetres in length and consist of a tiny tuft supported on 
a slender stalk. These seed, coarsely powdered and made into 
a paste, are used by the natives to poison their arrows, and 
are called Combe, Kombe, or Inee. From strophantus Dr. 
Thomas B. FraserJ has isolated a crystalline glucoside, which he 
calls strophantin, and to which the effects of the seeds are due. 
It is non-nitrogenous ; of a strongly-bitter taste and feebly-acid 
reaction, and is freely soluble in water and in rectified spirits, but 
not in ether. 

Effects and Uses — Pelikan in 1865 called attention to stro- 
phantus as a powerful cardiac poison, and his researches were 
confirmed by Fraser§, Corville||, and others. When introduced 

* Therap. Gaz.,Apv. 15th, 1886. 

f Bull. Gen. de Therap., Fevrier, 1888, p. 97. 

% Brit. Med. Jour., Nov. 14th, 1885. 

\ Op. cit.; also Proc. Royal Soc, 1879 ; Journ. Anat. and Phys., 1 872; Brit. Med. 
Jour., Jan. 22d, 1 887, and a monograph by Fraser " on the action of the digitalis group," 
containing a reprint of foregoing articles. || Med. Digest, Sec. 393; I, 1872. 



SPINANTS SPARTEINE. 2J^ 

into the system it increases the strength of the cardiac systole, 
while prolonging the diastole, and in over-doses arrests the 
heart in rigid systolic contraction. It is a muscle-poison, increasing 
the contractile power of all striated muscles, and renders their 
contractions more complete and prolonged, but the heart is easier 
influenced by it than are other muscles, and the dose may be so 
regulated that the cardiac effects are alone produced. It also 
contracts the arterioles somewhat, but not to the same extent as 
does digitalis. It produces a slight lowering of temperature and is a 
diuretic* It rarely causes vomiting and has no cumulative action. 

Strophantus, or strophantin has been used as a substitute for 
digitalis when the latter disagreed, or was objectionable from its 
effect in contracting the arterioles and thus throwing more work 
on an already overtaxed heart. 

A tincture (i to 20 parts by weight) is recommended by Prof. 
Fraser, of which the dose is f^j-xx, t. d. 

Of strophantin, gr. 1 ^ ^ may be given hypodermically. 

SPARTEINE. 

Sparteine (C 15 H 26 N 2 ) is an alkaloid obtained from Sarothamnus 
Scoparius, or Broom {Nat. Ord. Leguminosae), and occurs as a 
strongly alkaline, dense oily liquid, but slightly soluble in water, 
readily soluble in alcohol, ether and chloroform, having an 
intensely bitter taste and an aniline -like odor. It combines 
readily with acids to form salts, which are preferred for medi- 
cinal use because they are more readily soluble. 

Effects and Uses. — Like the other members of the digitalis 
group, sparteine is a cardiac tonic, acting through the central 
nervous system, increasing the intensity and persistence of the 
ventricular contractions and regulating cardiac rhythm. f 

In large doses it completely paralyzes the motor nerves and 
diminishes reflex action (Fick). It does not appear to affect 
muscular contractility. Sparteine is probably not the diuretic 
principle of Scoparius, and according to most observers has no 
effect on the urine, although Fick asserts that it increases diuresis. 

* Bull. Gen. de Therap., Aout 23d, 1888, Lemoine. 

-j- Archiv fur Experiment. Pathol, tmd Pharmakol., Fick. Band I, p. 397. 
Thise, Montpellier, 1887; " La Sparteine et ses Sels," par P. Dandrieu. Gaz. 
Hebdom., Nov. 27th, 1885, Germain See, et al. 



276 MATERIA MEDICA NEUROTICS. 

It does not disorder the stomach, has no cumulative action, and 
acts on the heart more promptly than digitalis (See). In over- 
doses it is capable of causing a fatal result, death being due to 
paralysis of the respiratory centre, and preceded by a stage of 
excitement, quickly followed by collapse. Poisoning from spar- 
teine should be treated by artificial respiration and electricity 
applied over the vagi. When it has been taken by the mouth 
in the form of sulphate, potassic iodide should be administered, 
as in the presence of water this seems to form an almost insolu- 
ble salt (Dandrieu), and in any event elimination should be 
favored by diuretics and diluents. // has been used with success 
in cases of weak, feeble and irregular heart, particularly when 
the cardiac rhythm is disturbed. It has also been used as a 
substitute for digitalis in cardiac dropsy and in cardiac dyspnoea, 
but that it can fully replace digitalis in the treatment of heart 
affections is yet not fully established. As its action is more 
rapid than digitalis, it may be used when prompt results are 
required, and thus gain the time necessary for the influence of 
the digitalis to manifest itself. 

The sulphate is the salt usually preferred and may be given in 
doses of gr. ss-ij t. d., in pill, capsule or solution. It is also used 
hypodermically. 

CIMICIFUGA. 

Cimicifuga racemosa, Black Snakeroot, or Cohosh (Nat. Ord. 
Ranunculaceae), is a very common indigenous perennial plant, 
growing to the height of from four to eight feet, with ternate 
leaves, oblong-ovate, incised and toothed leaflets, and small white 
flowers disposed in a long raceme. The rhizome and rootlets 
are the parts employed. The rhizome is a rugged, blackish- 
brown caudex, from a third of an inch to an inch in thickness, 
often several inches in length, furnished with numerous slender 
rootlets. Internally its color is whitish ; it has a peculiar faint, 
disagreeable odor and a bitter, somewhat astringent, taste. It 
imparts its virtues to boiling water, and contains gum, starch, two 
resins, tannic and gallic acids, and a volatile oil. The active prin- 
ciple has not yet been isolated, nor has a crystalline proximate 
substance been found.* 

* " Lloyd's Drugs and Med. of North America," Vol. I, p. 266. 



SPINANTS CIMICIFUGA. 



2/7 



Effects cmd Uses. — The effects of cimicifuga are not very accu- 
rately known. After large doses, vertigo, dilated pupil, and 
often hypnotic and anodyne effects are seen. On the circulation 
its effects are similar to, but less powerful than, those of digi- 
talis, as it slows the cardiac beat, while increasing the strength 



Fig. 




CIMICIFUGA RACEMOSA. 



of its contraction, and raising the arterial tension. It is undoubt- 
edly an active stimulant of the secretions, particularly those of 
the skin, mucous membranes and kidneys. It acts also on the 
uterus and unstriped muscles like ergot, but less powerfully. 
It increases the sexual appetite of the male and promotes the 



278 



MATERIA MEDICA NEUROTICS. 



menstrual flow of the female. It has been prescribed with 
advantage as an expectorant in chronic bronchial affections, and 
even in caseous pneumonia and phthsis. In fatty heart it is 
safer than digitalis, and may be used in dilated heart, languid 
circulation and oppressed breathing. It has also been used as a 
diaphoretic in rheumatism and as a diuretic in dropsies. As an 
antispasmodic in chorea it enjoys a high reputation. In the 
relief of after-pains, and in menorrhagia it is frequently of 
service, and it is a good remedy in subinvolution of the uterus. 
Administration. — Dose, in powder, gr. xx-5j. Of the fluid 
extract or tincture the dose is f5ss-j or ij. 

DEPRESSO-MOTORS. 
CONIUM. 

Conium maculatum, or Hemlock {Nat. Ord. Umbelliferse), is 
a biennial European plant, naturalized in many parts of the 



Fig. 22 




CONIUM MACULATUM. 



United States. Its stem is erect, from three to five feet high. 
The leaves are large and bright green ; the flowers are small, 



SPINANTS CONIUM. 279 

white, and arranged in umbels. The whole plant is narcotic 
and virulent, and has a fetid, heavy odor. The full-grown 
fruit (gathered while yet green, and carefully dried) is the only 
portion used. It has a yellowish-gray color ; a feeble odor, 
and a bitterish taste ; it is roundish ovate, a line and a half in 
length by a line in breadth, and striated. 

The active principle of hemlock is an alkaloid termed conine 
(C 8 H 15 N), which exists in larger proportion in the seeds than in 
the leaves. It is a colorless, transparent, volatile, oily fluid, of 
a peculiar repulsive, suffocating, mouse-like odor and a bitterish 
taste, sparingly soluble in water, and freely so in alcohol, ether 
and chloroform, and undergoes decomposition upon exposure 
to the air. It is a highly energetic poison, even in very small 
quantity; the dose of it is gr. -^. Other alkaloids, termed 
conhydrine (C 8 H 17 NO) and methylconine (C 8 H 14 CH 3 N), have been 
isolated ; all probably exist as malates. Conine combines with 
acids to form salts and unites with water as a hydrate. 

Physiological Effects. — The following account is based on the 
investigations of Lautenbach * (chiefly) and Hubert-Valleroux.f 
Local action : conine applied to a part produces loss of function 
of the tissues with which it is brought in contact. Nervous 
system : hemlock has but little influence upon the cerebral hemi- 
spheres, for in cases of poisoning from it, consciousness has 
been preserved to the last. A full medicinal dose induces the 
following effects : a sense of muscular fatigue and feebleness of 
the legs is felt, the eyelids droop, and vision becomes impaired, 
accompanied by dilatation of the pupil. In lethal doses conium 
causes paralysis, which is due to a paralyzing influence on the 
terminal extremities of the motor nerves. It impairs the con- 
ductivity of the sensory nerves, while its action on the cord is 
one of progressive depression (Lautenbach). The circulation 
is at first accelerated, then retarded, but further investigation 
is here required. The arterial pressure is at first lowered, and 
then decidedly raised ; the respiratory movements are not altered 
unless a poisonous dose has been taken, when the respiratory 

* Trans. Acad. Nat. Sci., Phila., 1875, p. 367 ; The Phys. action of hemlock and its 
alkaloid. 

f Arch. Gen. de Medecine 6 e ser. t. xvi, p. 83. De la cigue at son action phys. et 
Therap. 



280 MATERIA MEDICA NEUROTICS. 

centre is paralyzed and death ensues from asphyxia. Tempera- 
ture : some lowering of the animal heat has been noted ; but 
this, lately, has been denied by Lautenbach. Secretions : conium 
has no action on the glandular organs, except the salivary glands, 
the discharge from which it increases. Elimination : hemlock is 
eliminated in part by the urine, as it has been found there. Orfila 
detected it in the spleen, kidneys, and lungs. 

In large doses it causes nausea, vertigo, dimness of vision, 
relaxation of the muscles ; and in poisonous quantities, dilata- 
tion of the pupils, difficulty of speech, delirium or coma, 
paralysis, and finally convulsions (of cerebral origin) and death. 
It has no direct hypnotic effect. Like woorara, its characteristic 
physiological effect is the production of pure motor paralysis, begin- 
ning in the extremities and extending to the trunk, involving 
chiefly the terminal nerve-endings. In cases of poisoning, alco- 
holic stimuli are to be given, and as physiological antidotes, the 
tetanizing agents, as strychniue. 

Medicinal Uses. — It is employed as a general and topical ano- 
dyne, to relieve the pain of malignant tumors ; and, even if des- 
titute of the deobstruent powers which have been ascribed to it, 
it certainly exerts a remarkably palliative influence upon painful 
chronic indurations. It has also been recommended as an anti- 
spasmodic in whooping-cough, asthma, paralysis agitans, and as 
an anodyne in neuralgia ; as an adjuvant to other remedies in 
mania, and especially in melancholia; to moderate irritability of 
the sexual organs ; in diabetes ; to relieve the blepharospasm of 
many acute inflammations of the eye ; and it is used externally 
as a cataplasm to cancerous and irritable ulcers. Conium is 
quickly absorbed, and is eliminated with equal rapidity ; hence 
its effects are speedily induced, and are of brief duration. It is 
the cicuta of Hippocrates, Galen, and Pliny, and is supposed to 
have been the poison administered to Socrates and Phocion. 

Administration. — The dose of the powder, gr. ss-j. The 
extract {alcoholic) may be given in the same doses. An abstract 
is also officinal; dose, gr. %-). A tincture (dose f5ss-j) and 
a fluid extract are also used; of the flidd extract, in preparing 
which hydrochloric acid is employed to fix the alkaloid conine, 
the dose is i^iv-v, gradually increased until some effect is 
obtained. 



SPINANTS — PHYSOSTIGMA. 28 1 

The preparations of conium are uncertain, from the fact that 
the active principle is very volatile and easily escapes. Probably 
the best preparation is the fluid extract. 

PHYSOSTIGMA. 

Physostigma or Calabar Bean is the seed of Physostigma 
venenosum (Nat. Ord. Leguminosae), a perennial climbing plant 
of the western coast of Africa. The seed is about the size of a 
large horse-bean, irregularly kidney-form in shape, with a hard, 
brittle integument, and of a dark chocolate-brown color. The 
inner kernel is by far the more active portion. Alcohol, but not 
water, extracts its medicinal virtues. It yields an active alkaloid, 
termed eserine or physostigmine (Q5H21N3O2) sparingly soluble in 
water, but more soluble in alcohol, ether, and chloroform ; and 

Fig. 2^. 




CALABAR BEAN. 



recently another alkaloid, termed calabarine, which is believed to 
be a tetanizing agent, has been found in it in variable amount. 

The Calabar bean has long been used among the negroes of 
western Africa as an ordeal to determine the guilt or innocence 
of accused individuals, whence its name, the ordeal bean of 
Calabar. 

Physiological Effects. — It has been found, in full medicinal 
doses, to produce giddiness, torpor, paleness and coolness of the 
surface, weak and irregular pulse, relaxation of the muscular 
system, and drowsiness, but not stupor. An interesting effect of 
its action is a remarkable power of contracting the pupil, whether 
taken internally or applied externally ; its seems probable that 
this is accomplished by a local peripheral action — i. e., paralysis 
of the sympathetic terminals and stimulation of the oculo- 
motor fibres in the iris ; and it also contracts the ciliary muscle, 
which regulates the accommodating power of the eye. Ner- 



282 MATERIA MEDICA NEUROTICS. 

vous system : the brain is not directly affected by Calabar bean, 
the paralysis induced by it being due to a depressing action upon 
the spinal cord. In proof of this statement can be offered the 
fact that the muscular contractility and irritability of the motor 
and sensibility of the sensory nerves remains unimpaired in 
cases of poisoning by physostigma. The local application of a 
strong solution abolishes the functions of both kinds of. nerves 
(Fraser).* Lethal doses of physostigma cause total loss of 
reflex activity in the cord. Circulation : small doses of physos- 
tigma retard the heart's action by lengthening the diastolic pause, 
while toxic doses arrest it in diastole, but before the movements 
are extinguished there is a marked fall in blood pressure. The 
stoppage is probably due to paralysis of the cardiac ganglia. 
Respiration : toxic doses of physostigma cause slowing of these 
movements, and eventually they are abolished, death ensuing 
from asphyxia. Intestines : Calabar bean increases decidedly 
intestinal peristalsis. Increase of the salivary secretion has 
been observed. A poisonous dose of physostigma in man 
causes nausea, giddiness, muscular weakness and tremors, dimin- 
ished heart action, abolition of reflex action, slow respiration, 
myosis and motor-paralysis. It is allied in its effects to woorara 
and conium, but differs from them in its tendency to produce 
muscular twitchings, and contraction of the pupil. In cases of 
poisoning, after emptying the stomach, the hypodermic admin- 
istration of a solution of atropine is the best physiological 
antidote. Chloral mitigates the symptoms. 

Medicinal Uses. — Calabar bean has been found highly effica- 
cious in traumatic tetanus, but it must be given in doses large 
enough to attain decided effects. Fraser advises the exhibition 
of eserine hypodermically, in severe cases. It has been used 
also with success in chorea, in poisoning from strychnine, and 
in spasmodic cholera. In ophthalmic surgery its employment 
is obvious, either to produce contraction of the pupil or to 
increase the power of accommodating the eye to distances. 

The dose of the kernel is laid down as gr. ij-iij, to begin 
with, gradually increased. By exhausting the kernel with alco- 

* For an elaborate account of the action of Calabar bean, consult Dr. T. R. 
Fraser's Thesis, 1863. 



SPINANTS CHLORAL. 283 

hol, and subsequent evaporation, an extract is obtained, of whfch 
the dose is gr. y&. A good form of administration is the tinc- 
ture (100 parts contain io parts of powder) ; dose, n^v-xv ; or 
a solution in glycerin may be used. Eserine itself, or as a salt, 
one part to a thousand in solution, may be applied to the eye ; 
dose, internally, gr. ^ ^ 2 . Physostigmince salicylas is officinal. 
It is the most stable salt of the alkaloid, but its slight solubility 
in water renders it of little value for hypodermic injection. 
Dose, gr. £ b ^ 2 (Stille and Maisch). Gelatin-disks are now 
much used in ophthalmic practice. 

CHLORAL. 

This interesting compound, although discovered by Liebig 
in 1832, has attracted attention as a therapeutic agent only 
since the statements of Liebreich, a physician of Prussia, pub- 
lished in May, 1869. It is prepared by passing dried chlorine 
gas through pure anhydrous alcohol, afterward gently heating, 
when the liquid separates into two layers, the lower of which 
is chloral ; this is agitated with sulphuric acid, and purified by 
distillation, first over sulphuric acid and then over quicklime ; 
the reaction, upon which the formation of chloral depends, in 
this process, is complicated, chloral and hydrochloric acids 
being the chief products. Anhydrous chloral (C 2 HC1 3 0) is a 
thin, limpid, oily, colorless liquid, greasy to the touch, with a 
fatty taste, and a strong pungent smell, producing lachryma- 
tion. Chemically, it is classed with the halogen aldehydes. 
It has a sp. gr. of 1.502, a boiling point of 203 F., and mixes 
in all proportions with water, alcohol, ether and chloroform. 
Mixed with one-eighth its weight of distilled water, it combines 
to form a so-called hydrate (C 2 HC1 3 0,H 2 0), for it contains an 
entire molecule of water, which crystallizes in a mass of snow- 
white needles, soluble in their own weight of water ; and, as 
pure chloral readily undergoes decomposition, the more stable 
hydrate is the form which is employed for medicinal use. It 
is incompatible with the alkalies, which decompose it into formic 
acid and chloroform. 

Chloral combines also with alcohol, forming a compound 
termed Chloral Alcoholate, which resembles the hydrate, but is 



284 MATERIA MEDICA NEUROTICS. 

distinguishable by its insolubility in water and its solubility in 
cold chloroform. 

Effects and Uses. — Chloral has decided antiseptic properties, 
as pointed out by Keen ;* and it is also an irritant. Nervous 
system : in doses of 20 grains, chloral is a most reliable hypnotic, 
the sleep being usually quiet, natural, and refreshing.f Gener- 
ally, no unpleasant effects follow its employment, though occa- 
sionally headache and slight nausea supervene. According to 
Hammond, chloral causes cerebral anaemia, the brain being in 
this condition when chloral-sleep sets in. In medicinal doses, 
it is not a pain-relieving agent, in the way that opium is. In 
hypnotic doses, it slightly contracts the pupil. Da CostaJ states 
that it has no special action on the secretions, except some 
augmentation of the urine, and it is probably eliminated by the 
kidneys. When larger amounts are given, the sleep is deeper, 
and may pass into coma ; the respiration is slower ; the pulse is 
reduced in fullness and frequency, the arterial tension being 
lowered ; the temperature is reduced ; the muscular system is 
relaxed ; and both sensibility and reflex actioji are abolished, the 
latter being brought about by a direct action on the spinal cord, 
since chloral does not affect the motor nerves nor muscular con- 
tractility. Ringer§ found that it affected the cardiac tissues 
directly and ultimately stopped the heart in diastole, the contrac- 
tility of the muscle-substance being extinguished by it. 

Large amounts may be taken without fatal results, as 460 grains 
have been given without unpleasant effects, though gr. xx, in three 
cases, proved poisonous, and gr. xxx killed an adult female || ; 
The symptoms of poisoning are profound sleep, diminished fre- 
quency of the respiration and circulation, redness of the con- 
junctiva, contraction of the pupils, lividity of the lips, and falling 
of the jaw, with occasional eruptions of the skin. Death takes 
place probably from sudden failure of the heart's action, which 
stops in diastole, or from paralysis of the respiratory centre. 

* Amer. Jour. Med. Set., July, 1875. 
f Bull. Gen. de Tkerap., lxxvii, p. 307, Demarquay. 
% Am. Jour. Med. Set., April, 1870, p. 309. Clinical notes on chloral. 
\ Brit. Med. Jour., March 10th, 1883. Experimental investigation on the action 
of chloral, etc. || The Lancet, March 25th, 1871, 403. 



SPINANTS CHLORAL. 285 

The treatment of chloral-poisoning is much the same as that 
pursued in opium-poisoning ; artificial respiration should always 
be resorted to before the respirations cease. Strychnine has 
been recommended to prevent cardiac failure, but according to 
Dr. Kobert, while chloral is the best antidote for poisoning by 
strychnine, their antagonism is not reciprocal, as the latter 
neither prevents the respiratory arrest, nor counteracts the de- 
pressing effect of chloral on the heart, nor prevents the lowering 
of the bodily heat. Atropine is probably the best antidote in 
cases of chloral-poisoning ; it should be given frequently, guided 
by the respiration, and the temperature of the body should 
be maintained by the application of dry heat. It was formerly 
asserted that chloral is decomposed in the blood by the liberation 
of chloroform ; but this is not the case, as Amory has proved,* 
for no chloroform could be detected in the breath or blood of a 
dog poisoned by chloral, but on introducing chloroform by 
enemas this drug was found in the blood and respired air at 
once. 

Chloral is a most valuable hypnotic remedy in all the forms 
of insomnia, in hysterical excitement, in acute mania, and in 
delirium tremens. As an antispasmodic, large doses are re- 
quired. It has been used with advantage in infantile convul- 
sions, and even in puerperal and uraemic convulsions, both by the 
mouth and hypodermically, and it is especially recommended in 
the relief of rigid os during labor. In sea-sickness it is highly 
recommended, though nothing is of much service in this com- 
plaint. In tetanus, much success has been obtained with chloral, 
in ten-grain doses every two hours. In whooping-cough, 
chorea, etc., it has also been employed with advantage, and as 
an antidote for strychnine. As an anodyne it is available, but 
only in narcotic amounts. The ordinary dose of chloral is 20 
grains, which may be safely repeated every hour or two, till 
three doses have been taken or sleep occurs. An equal weight 
of chloral hydrate added to powdered camphor makes a valuable 
local anaesthetic liquid. 

Chloral is administered only in aqueous solution, and the addi- 



* N. Y. Med.Joum.yXV, 1872, 606 ; also Journal de Panatotnie et de laphysiologie, 
1870-71, p. 570. 



286 MATERIA MEDICA NEUROTICS. 

tion of mucilage or syrup, particularly of the syrup of orange- 
peel, will disguise its unpleasant taste. It is not well adapted to 
the hypodermic method, as painful phlegmons sometimes follow 
its repeated use. Locally, in dilution (gr. x to f§j of water), or 
as an ointment (5ss to §j), it is a good stimulant and deodorizing 
application to foul and fetid indolent ulcers ; as an injection in 
gonorrhoea (gr. xx to f§j of water), it answers well; and injected 
into subjects for the dissecting room (Keen, loc. cit.), and in the 
preservation of anatomical preparations, it has been also found 
useful (gr. xl to fSj of water). 

Croton-Chloral Hydrate (more correctly termed butyl- 
chloral hydrate) (C 4 H 5 C1 3 0.H 2 0) is made by the action of chlo- 
rine upon ethylic aldehyde, and, when pure, occurs in beautiful 
white, silvery crystals, with a sweetish melon flavor, only slightly 
soluble in water. Its action is similar to chloral, though thought 
to be feebler ; in addition it causes anaesthesia of the head. It 
is useful as an anodyne in neuralgia, and also in chronic cough, 
in doses of from gr. xv-xx, dissolved in glycerin and syrup. 

POTASSII BROMIDUM POTASSIUM BROMIDE. 

Potassium bromide (KBr) is prepared by adding a solution of 
pure potassium carbonate to a solution of ferrous bromide. The 
iron is precipitated, and the potassium bromide remains in solu- 
tion, from which it is obtained by evaporation. It occurs as a 
permanent, colorless, anhydrous, crystalline salt, of a pungent, 
saline taste, very soluble in water, and slightly so in alcohol. 
When mixed with starch, a yellow color is developed on the 
addition of chlorine. A bluish tint shows the presence of an 
iodide. 

The statement of the action of potassium bromide is based on 
the investigations of Amory,* Bill,f Nuneley,J Bartholow,§ 
Lasegue,|| Damourette et Pelvet.T 

Physiological Effects. — Local action : when applied locally to 
the pharyngeal mucous membrane, it is said to lessen the reflex 

* Pamphlet, 1869. " Exper. upon the Phys. Action of Bromide of Potassium, etc." 
f Am. J. Med. Sci., July, 1868. % The Practitioner, III, 347. 

\ Pamphlet, 16 pp. " Exp. Investigation into the Actions and Uses of the Bromide 
of Potassium." || Arch. Gen. de Medecine, t. VI, 6th Ser., p. 81. 

\ Bull. Gen. de Thirap., LXXin, pp. 241, 289. 



SPINANTS POTASSIUM BROMIDE. 287 

irritability of the part. Nervous system : when applied locally 
to the motor nerves and spinal centres of the frog, potassium 
bromide destroys their functions. This action, however, is prob- 
ably due to the potassium which it contains (Ringer), and is 
shared by other potassium salts. When administered internally 
(in animals), the irritability of the brain is decreased, owing in 
great part to the anaemia caused by the action of the drug upon 
the vaso-motor nerves which govern the calibre of the vessels. 
Reflex irritability is diminished, partly on account of the para- 
lyzing influence exerted on the reflex functions of the cord, and 
in part from paralysis of the end-organs of the peripheral nerves ; 
on the latter account, also, cutaneous sensibility is lessened. It 
possesses a sedative action on the sympathetic system, giving 
rise to diminished cardiac action, decrease in the blood supply 
to various organs, and slight reduction in the temperature of the 
body. Circulation : topically applied to the heart (and volun- 
tary muscles), it destroys their functions, as in the case of the 
topical application to the nervous centres, and probably for the 
same reason. In very large doses it lessens the frequency and 
force of the cardiac contractions, shortening the systole, pro- 
longing the diastole, and, finally, paralyzing the heart in diastole. 
The tension of the arterial system is lowered. Respiration : it 
slows respiration and causes death by arrest of the respiratory 
centres (Ott). Temperature : in warm-blooded animals, toxic 
doses lower very decidedly the temperature, probably due to a 
direct checking of tissue changes. Secretion : at first the secre- 
tions and excretions are diminished, but, later, they are increased 
in amount. If a very large dose is taken, they are increased 
primarily. No lachrymation, salivation, or catarrh is produced, 
as after the administration of the iodides. After large doses, 
micturition is less frequent, because the vesical irritability is 
diminished, — not because the amount of urine is decreased. A 
very large dose may paralyze the sphincter and produce incon- 
tinence of urine. The amount of urea eliminated is diminished 
as is, also, the amount of carbonic acid exhaled from the lungs, 
and the perspiration is decreased. 

In man, the action of the bromides is similar to the action in 
animals ; the cerebral symptoms being, however, more marked, 
because of the greater development of the hemispheres. When 



288 MATERIA MEDICA NEUROTICS. 

long continued, potassium bromide exerts a very marked 
depressing effect upon the sexual functions, enfeebling their 
vigor, and with it the sexual appetite. These symptoms pass 
away when the drug is withheld. When considerable doses are 
given for a long period, a train of symptoms is produced to 
which the name bromism is applied. These are mental weakness, 
great drowsiness, failure of memory, anaemia, malnutrition and 
depression of spirits, with, often, impaired sensibility of the 
mucous and cutaneous surfaces, diminution of the sexual func- 
tions, and an eruption on the skin (generally on the face and 
back), usually of acne, which rarely suppurates, occasionally of 
eczema, and, very rarely, rupial ulcers may be seen. Elimina- 
tion : potassium bromide is eliminated chiefly by the kidneys ; 
but also by the mucous membranes of the fauces, intestinal 
canal and bronchi, by the skin, and by the salivary glands. It 
is absorbed by the blood rapidly (Bartholow, lac. cit.) as traces 
may be found in the urine ten minutes after its administration, 
but elimination is slow. According to Amory (lac. cit), it passes 
out, when given in medicinal doses, undecomposed, by the skin 
and kidneys. No case of acute poisoning by potassium bromide 
has been reported. 

Antagonists and Incompatibles. — Acids, acidulous and metallic 
salts are incompatible with potassium bromide. It is antagonized 
in its physiological action by alcohol, ether, coffee, cold, digitalis, 
strychnine, belladonna, ergot, and other remedies which stimu- 
late the vaso-motor nerves and induce arterial congestion. 

It is aided in its action on the brain by cannabis indica, chloral, 
opium, and similar remedies ; the depressing effects on the cir- 
culation are enhanced by aconite, veratrum viride, gelsemium, 
etc. 

Medicinal Uses. — From its action on the nervous system, 
potassium bromide is much used to quiet cerebral excitement 
and for its sedative effect on the reflex centres of the cord. As 
a narcotic (by causing anaemia of the brain), it is much used in 
wakefulness due to cerebral hypersemia, or even when not more 
than the normal amount of blood is sent to the brain ; in wake- 
fulness and wandering during convalescence from acute diseases ; 
and in sleeplessness due to worry, grief, dyspepsia, and over- 
work ; also in cases of night-horror in children, where they 



SPINANTS POTASSIUM BROMIDE. 289 

awake suddenly and scream with fright, often for a considerable 
time, small doses of this salt and a light supper will frequently 
effect a cure ; adults subject to nightmare will find relief, too, in 
the temporary use of potassium bromide ; to allay restlessness, 
remove delusions, calm delirium, and produce sleep in the early 
stages of delirium tremens, it is given in doses of gr. xx to xxx 
every two hours until sleep is produced. It is more efficient in 
the early stages, and can be relied on with more certainty in the 
first than in subsequent attacks. 

Potassium bromide is often combined with other narcotics, as 
opium, chloral, etc., to aid their action, and even to modify their 
disagreeable effects. It will generally prove beneficial in women 
suffering from nervousness ; great despondency, amounting to a 
feeling of approaching madness ; irritability ; lack of interest in 
their surroundings ; sleeplessness and harassing dreams, caused 
by overwork, want of change, grief, or worry. If the medicine 
does not succeed alone, it will when combined with a change of 
scene. In some cases of hysteria, potassium bromide is a 
valuable remedy. In all forms of convulsions (epilepsy, chorea, 
convulsions of Bright's disease, convulsions of children, etc.) it 
will prove beneficial, by diminishing the reflex function of the 
cord. 

In epilepsy the bromides are preeminently of service, lessening 
the frequency of the attacks, if not absolutely preventing their 
recurrence. It is stated by Trousseau and by Bartholow that it 
is less efficient in attacks of petit mal than in those of severer 
form ; but Dr. A. Hughes Bennett has recently published a 
number of cases of the lighter variety, in the majority of which 
the bromides proved successful. It should be given in doses 
sufficient to prevent reflex retching or nausea, when the fauces 
are tickled (Voisin), and must be continued for years, with an 
occasional intermission of a week or two. 

Potassium bromide has been successfully used in the treat- 
ment of strychnine-poisoning; it should be given in doses of 5ij, 
frequently repeated, as the case may require. It has also been 
successfully used in tetanus. It has been recommended during 
dentition, to allay irritability and restlessness and prevent convul- 
sions. In the reflex forms of vomiting, as the vomiting of preg- 
nancy and of sea-sickness, and in migraine or sick headache 
19 



29O MATERIA MEDICA NEUROTICS. 

(especially in the congestive forms), it is sometimes beneficial 
In the colic of infants, unaccompanied by diarrhoea, it is an 
excellent remedy, relieving pain and spasm, and producing sleep. 
It is used, too, in large doses, 5j or more, to obtund the sensibility 
of the fauces, before the exhibition of the laryngoscope, but this 
is going out of fashion since the introduction of cocaine. 

From its sedative influence on the organs of generation, it is 
used with success in nymphomania, spermatorrhoea and mastur- 
bation. It decreases the flow of blood in menorrhagia. The 
flushes of heat, followed by sweating and prostration, occurring 
at the menopause, are generally cured by the use of potassium 
bromide. 

Administration. — Dose, gr. v-5j or more. In epilepsy it is 
given in doses of gr. xx— xxx, thrice daily, and continued for a 
long period, with occasional intervals of a week or two. If 
bromism occur, stop the remedy for the time, and give tonics. 
The bromide rashes are easily cured by withdrawing the medicine, 
and giving liquor potassii arsenitis internally in small doses, and 
the local use of an ointment containing iodide of sulphur. 
Potassium bromide should be administered in solution, and 
preferably between meals. 

AMMONII BROMIDUM AMMONIUM BROMIDE. 

Ammonium bromide (NH 4 Br.) is prepared by mixing bromine 
with iron-wire in distilled water, agitating the mixture until the 
liquid assumes a greenish color, and then adding water of ammo- 
nia to the mixture, which precipitates the iron as ferrous hydrate, 
ammonium bromide remaining in solution. By filtration and 
evaporation, a white, granular salt is obtained, which, on exposure 
to the air, gradually becomes yellowish (in consequence of the 
liberation of hydrobromic acid), has a saline, pungent taste, is 
very soluble in water, and moderately so in alcohol. 

Physiological Effects. — The action of ammonium bromide 
lesembles, in many respects, that of the potassium salt. When 
applied locally to the motor nerves, spinal centres, heart, or 
voluntary muscles, it does not destroy their functions, and has 
less influence, when administered internally, on the circulation, 
respiration and temperature. 

Medicinal Uses. — It has been used for the same conditions in 



SPINANTS AMMONIUM BROMIDE. 29 1 

which potassium bromide is given. Echeverrhia prefers fhe 
ammonium bromide in epileptic maniacal excitement, but states 
that it will fail unless combined with chloral, cannabis indica, 
or other narcotic, or, better still, with ergot. The combined use 
of ammonium and potassium bromide has been recommended 
by Brown-Sequard. Da Costa highly recommends its use in 
acute rheumatism. It has also been used with advantage in 
pertussis. 

Administration. — It is given in doses of gr. v-xxx, thrice daily, 
and is best administered in some bitter infusion. 

Sodii Bromidum {Sodium Bromide) (NaBr) may be prepared 
in a similar manner to potassium bromide. 

In its physiological effects it resembles potassium bromide, but 
is much feebler. 

It is used in the same diseases and in the same doses as is the 
potassium salt. 

Lithii Bromidum {Lithium Bromide) (LiBr) has been recom- 
mended as the most efficacious of the bromides. S. Weir 
Mitchell has found it efficient in gr. x-xx doses, in some cases 
of epilepsy, after potassium bromide had failed. It has been 
used in gout, but not with much success. It contains a larger 
per cent, of bromine than do the other salts, and is very soluble. 

Calcii Bromidum {Calcium Bromide) (CaBr 2 ) has been em- 
ployed for the same purposes and in the same doses as potas- 
sium bromide. 

Zinci Bromidum {Zinc Bromide) (ZnBr 2 ) has been employed 
in the treatment of epilepsy, but its use is not general. Ham- 
mond * has obtained beneficial results with the salt in arresting 
the epileptic paroxysms where the other bromides had failed, 
and it has the advantage of not causing bromism or a cutaneous 
eruption. Dose, gr. ij-xx, in syrup and water. 

Acidum Hydrobromicum Dilutum {Diluted Hydrobromic Acid) 
is a clear, colorless liquid, without odor, but having a strongly 
acid taste, which consists of 10 per cent, of absolute Hydro- 
bromic acid (HBr), and 90 per cent, of water. It has a sp. gr. 
of 1.077. 

Effects and Uses. — This acid does not differ materially. in its 

* " A Treatise on Diseases of the Nervous System," 1888, p. 716. 



292 MATERIA MEDICA NEUROTICS. 

action from potassium bromide, and has been used as a substi- 
tute for it in epilepsy, alcoholism, congestive headache, vertigo, 
chorea, insomnia, hysteria, post-hemiplegic disturbances, etc. 
It has been recommended to combine it with quinine as a pre- 
ventive of cinchonism. Its value does not seem to be very 
firmly established. Dose of the diluted acid, f5ss— ij, 

TABACUM TOBACCO. 

Nicotiana Tabacum, or Virginia Tobacco (Nat. Ord. Solana- 
ceae), is a native of the warm countries of America. . It is an 
annual plant, growing to the height of from three to six feet, with 
large oblong, pointed, hairy, pale-green leaves, and light-greenish, 
funnel-shaped flowers. The dried leaves are the portion used. 
They have a yellowish-brown color, a strong, peculiar, narcotic 
odor, and a bitter, nauseous taste. The darker-colored leaves 
are the strongest. 

The virtues of tobacco are imparted to alcohol and water, and 
depend on the presence of an alkaloid called nicotine (C 10 H 14 N 2 ) 
(as a malate), which is found in all parts of the plant, but not in 
tobacco-smoke. It is a colorless, oily, volatilizable, alkaline 
liquid, highly soluble in water, alcohol, ether, chloroform, the 
fixed oils, and oil of turpentine, of a feeble odor when cold, but 
irritant when heated, of an acrid, burning taste, and is a most 
energetic poison, ranking after prussic acid. From the dried 
leaves are also obtained a concrete volatile oil, termed nicotianin, 
which is probably the odorous principle of the plant, and an 
empyreumatic oil, which gives the peculiar smell to old tobacco 
pipes. Both of these principles are poisonous. Tobacco-smoke * 
has been found " to contain numerous basic substances of the 
picolinic series, and ceded to caustic potash, hydrocyanic acid, 
sulphuretted hydrogen," with fatty acids, phenol and creasote. 

Physiological Effects. — Local action: applied to the skin tobacco 
is readily absorbed. On persons unaccustomed to its use, 
tobacco, in small doses, produces nausea, depression, and a feel- 
ing of wretchedness. Nervous system : tobacco expends its 
action on the spinal cord, and not upon the brain, and nicotine, 
in full doses, acts as a tetanizing agent on man. Nicotine con- 

*" Pharmacographia," 2d ed., p. 468. 



SPINANTS TOBACCO. 293 

tracts the pupil either locally or internally. The conductivity of 
the motor nerves is more or less abolished, and lastly that of the 
spinal cord, while the voluntary muscles remain unaffected. These 
remarks apply to lethal doses of the drug. Circulation : the red 
globules of the blood of a person under the influence of tobacco 
present a crenated appearance. Tobacco is not a cardiac poison, 
since the application of nicotine to the cut-out heart will not 
stop its beats ; nevertheless it slows the cardiac action and tem- 
porarily reduces the blood pressure. It causes death by paralyz- 
ing the muscles of respiration. Intestines : tobacco has a relax- 
ing influence upon this tract, and the injection of nicotine induces 
intestinal peristalsis. Nicotine is probably eliminated by the 
kidneys. In larger doses, it induces vomiting and purging, a 
sensation of sinking at the pit of the stomach, giddiness, disorder 
of vision, contraction of the pupils, depression of the circulation, 
great relaxation of the muscular system, coldness of the surface, 
and other symptoms of prostration ; and, when excessive doses 
have been taken, these symptoms become more violent, and are 
followed by clonic convulsions, paralysis and death. 

Woodman and Tidy * have collected a number of fatal cases 
from the use of tobacco-infusion by clyster and injection, so that 
it is a remedy, even locally, to be employed with caution. Cases 
of poisoning are to be treated with the diffusible stimuli, after 
washing out the stomach, and strychnine is to be used hypoderm- 
ically; dry heat should also be applied, and, if these means fail, 
artificial respiration should be resorted to. 

The habitual use of tobacco as an exhilarant is well known. 
When taken to excess, it frequently develops disorders of the 
stomach, heart and nervous system. 

Medicinal Uses. — Tobacco is employed in medicine chiefly 
with a view to its action on the muscular system — its anodyne 
properties being relatively feeble. In various spasmodic diseases, 
particularly in colic, ileus, strangulated hernia, constipation from 
spasmodic constriction, tetanus, spasm of the neck of the bladder 
and the glottis, and asthma, it was formerly considered a remedy 
of great value, but more efficacious ones have superseded it. 
Internally, tobacco is to be employed with caution, as it occasion- 

*" Forensic Medicine, etc.," 1882, p. 381. 



294 MATERIA MEDICA NEUROTICS. 

ally acts with dangerous energy. It is now rarely used medici- 
nally. 

Administration. — Tobacco is not given by the stomach, owing 
to its emetic properties. It is usually administered by the rec- 
tum, in the form of infusion, or tobacco-smoke may be introduced 
into the rectum. It may also be smoked for medicinal effect, or 
applied locally in the form of cataplasm. The oil is sometimes 
mixed with ointments. 

LOBELIA. 

Lobelia inflata, or Indian tobacco {Nat. Ord. Lobeliaceae), is 
a very common annual or biennial indigenous plant, growing to 
the height of from six inches to two feet, an erect, hairy stem, 
ovate, serrated leaves, pale-blue flowers, and ovoid, inflated cap- 
sules. All parts of it are active, but the leaves and tops only 
are officinal. Water and alcohol extract the virtues of lobelia, 
which contains a partly volatile alkaloid, lobeline, lobelic acid, 
fixed and volatile oil, gum, chlorophyll, etc. Lloyd* regards 
the alkaloid as a fixed one ; he also isolated a substance termed 
inflatin. Lobeline is a yellowish liquid, lighter than water, of 
an aromatic odor, an acrid taste, soluble in water, but more so 
in alcohol and ether. 

Pliysiological Effects. — Lobelia produces effects on the system 
analogous to those of tobacco, acting in small doses as a sedative, 
nauseant and diaphoretic. According to Ott's f investigations, 
the alkaloid produced in the rabbit curious alterations of blood- 
pressure, viz. : first a fall, followed generally by a rise, and lastly 
a very decided fall ; also slower respiration, paralysis, reduction 
of temperature, and death from asphyxia. Lobelia, like tobacco, 
retards the heart's action, is said to increase the urinary flow, 
and, in an unexplained way, relieves bronchial spasm. There 
are on record numerous cases of death from large doses of 
lobelia. Complete investigations of its action have not yet been 
made. In large doses it is an energetic emetic ; and in still 
larger doses destroys life by paralyzing the respiratory centre 
in the medulla oblongata, the pupil being contracted. It was 
employed by the aborigines, and has always been a popular 
empirical remedy. 

*" Drugs and Medicines of North America," Vol. II, p. 75. 
+ Boston Med. and Surg. Jour., 1875. 



SPINANTS LOBELIA. 



295 



Medicinal Uses. — Lobelia is sometimes classed among emetics, 
but its action in this particular is too violent for its safe adminis- 
tration. It is chiefly employed, by regular practitioners, in virtue 
of its bronchial antispasmodic properties for the relief of asthma, 
angina pectoris, and cardiac dyspnoea, and is given in small doses, 



Fig. 24. 




LOBELIA INFLATA. 



gradually increased until headache or nausea ensues. In asthma, 
Ringer advises lobelia to be given in large doses, viz., f5j of the 
tincture every hour, or even every half-hour. The chief draw- 
back to its use is its uncertainty and the nausea and depression 
induced by it. In asthma it possesses no curative power, seeming 



296 MATERIA MEDICA NEUROTICS. 

to be beneficial by reason of its antispasmodic and expectorant 
properties. It may also be used as an enema, to fulfill the same 
indications as tobacco. 

Administration. — Lobelia is given in substance, tincture, and 
infusion. The dose of the powder as an antispasmodic is gr. 
j-iij ; as an emetic, gr. v-xx. The best form, particularly in 
asthma, is the tincture (20 per cent., in diluted alcohol), which 
may be given in the quantity of foss— j, to be repeated as occasion 
may require A fluid extract is also officinal ; dose, ^j— xxx. 

Acetum LoBELiiE (Vinegar of Lobelia), made with diluted 
acetic acid, is a good preparation, in which the alkaloid is fixed 
by the acetic acid; it contains 10 per cent, of lobelia. Dose, as 
an expectorant, f5ss-j ; as an antispasmodic and nauseant, f5j-ij. 

ACIDUM HYDROCYANICUM DILUTUM DILUTED HYDROCYANIC ACID. 

Hydrocyanic acid, known also as cyanhydric acid and prussic 
acid, is derived from a variety of vegetable substances, as the 
bitter almond, peach kernels and leaves, wild cherry, cherry 
laurel, etc. It is employed in medicine only in a state of ex- 
treme dilution ; and the diluted acid is obtained by the action 
of sulphuric acid and water on potassium ferrocyanide, or 
when wanted for immediate use, by the action of hydrochloric 
acid and water on silver cyanide. 

Diluted hydrocyanic acid is a colorless, volatile liquid, with a 
peculiar odor and a cooling, somewhat irritating taste. It under- 
goes decomposition if exposed to the light, and should be kept 
in bottles covered with black paint or paper ; but it is not a 
stable preparation. It contains two per cent, of the anhydrous 
or concentrated acid. 

The anhydrous acid(HCy or HNC) is a colorless, feebly acid, 
transparent, very volatile and decomposable liquid, with a pow- 
erful, peculiar odor, and a cooling, afterward burning taste. 
Both water and alcohol dissolve it readily. Its presence in a 
suspected mixture may be detected by the addition of a solution 
of silver nitrate, which throws down a white, curdy precipitate 
of silver cyanide, distinguishable by its giving off, when dried 
and heated in a test tube, cyanogen gas which will burn with a 
rose-colored flame (the silver test is the most delicate, when 
applied to prussic acid in the state of vapor) ; or, by adding to 



SPINANTS DILUTED HYDROCYANIC ACID. 297 

the suspected solution a little liquid potassae, and then a mixed 
solution of ferrous and ferric sulphate, a dirty greenish-blue 
precipitate is thrown down, which, on the addition of a few drops 
of pure hydrochloric acid becomes Prussian blue (the best 
liquid test). 

Physiological Effects. — Locally: hydrocyanic acid applied 
directly to the skin exerts a benumbing influence, and may be 
absorbed with the aid of friction ; to a mucous membrane or 
wound it is readily taken up. Nervous system : in small doses 
it produces no symptoms beyond a calming effect. Full doses 
cause giddiness, confusion of mind, and muscular feebleness. 
Whether large doses act on brain, vagus, or peripheral nerves 
is disputed. The convulsions which it produces are cerebral, 
for they do not occur in parts cut off from the cord. In the 
frog, Kolliker* finds that the direct application of hydrocyanic 
acid paralyzes the motor nerve trunks, and destroys the irrita- 
bility of muscle, and upon the peripheral sensory nerves acts as 
a paralyzant. Since hydrocyanic acid produces asphyxia most 
rapidly in the form of vapor, Preyer concludes that it acts 
directly on the pulmonary ends of the vagi. That it acts 
directly on the nerve centres is supported by the experiment of 
Jones, f in which the application of the acid to the medulla of 
an alligator caused quickly collapse of the lung. Circulation : 
prussic acid in small doses has a sedative action on the heart ; 
large doses arrest it in diastole (Lecorche et MeuriotJ). When 
applied directly to the heart it suspends its movements. Under 
prussic acid a temporary increase of the arterial pressure, fol- 
lowed by a permanent reduction, has been observed. But this 
is not in accordance with Lecorche and Meuriot's (loc. cit.) inves- 
tigations. It is only in lethal doses that opinion is unanimous 
as to a decided reduction of blood-pressure. Respiration : 
nothing short of 10-15 min. disturbs this act, this amount 
rendering it labored and irregular. Large doses destroy life so 
quickly that the respirations cannot be counted. Prussic acid 
has no influence on temperature, nor on secretion, save a slight 

* Arch, fur Pathol. Anat., Bd. x, p. 272. 
\ N. Y. Med. Record, II, 1867, 456. 

% Arch. Gen. de Medecine, 6 ser., x i, p. 529. Etude Phys. et Therap. sur l'acide 
cyanhydrique. 



298 MATERIA MEDICA NEUROTICS. 

augmentation of saliva. Elimination is rapid, taking place by 
the saliva, kidneys and lungs. Opinions as to the action of 
prussic acid on the blood are contradictory. During life, under 
hydrocyanic acid, the venous blood is found to have an arterial 
hue ; while in man and mammals, after death this fluid is 
dark colored, probably from deficient abstraction of carbon 
dioxide. Outside of the economy the addition of hydrocyanic 
acid to the blood produces a new body, formed from HCy and 
hemoglobin, called cyanohemoglobin (Hoppe-Seyler *), which 
has no ozonizing power, and it seems probable that the forma- 
tion of this substance, if it take place during life in the blood, 
may be one of the main factors in causing death. In a poison- 
ous dose, hydrocyanic acid arrests life with fearful rapidity, and 
is one of the most energetic poisons known, one or two drops 
of the pure acid being sufficient to destroy a dog in a few 
seconds, and gr. -^ f of the anhydrous acid killed an adult in 
twenty minutes. When not immediately fatal, it produces great 
and sudden prostration, difficult and spasmodic respiration, dila- 
tation and immobility, and sometimes contraction of the pupils, 
feeble pulse, diminution of temperature in the extremities, rise 
of temperature in the trunk at first, but afterward fall of tem- 
perature, and involuntary evacuations. It acts on both the 
voluntary and involuntary muscles, decreasing or arresting 
entirely their property of contractility ; both the sympathetic 
and cerebro-spinal nervous systems appear to be affected. The 
best antidotes are inhalations of ammonia or its carbonate, and 
(if the patient can swallow) alcoholic stimuli are to be employed, 
and at the same time cold and hot affusions and artificial respira- 
tion must also be resorted to. The subcutaneous injection of 
atropine sulphate has been proposed as a physiological antidote, 
but its rate of diffusion is too slow to be of service, while 
Boehm % states that it is not antagonistic at all. 

Medicinal Uses. — Hydrocyanic acid is a valuable agent in 
allaying spasm, pain and nervous irritability, in a variety of dis- 
orders, and is much used to relieve cough, particularly in phthisis 
pulmonalis, and for its antispasmodic virtues in asthma and 

* Virchows Archives, xxxvni, p. 435. " Ueber die Ursache der Giftigkeit der 
Blausaure." f " Taylor's Med. Jurisprudence," 3d Am. ed., 142. 

% Practitioner, XIII, p. 168. 



SPIN ANTS DILUTED HYDROCYANIC ACID. 299 

whooping-cough. It is, moreover, a most efficacious remedy, in 
gastrodynia and in neuralgic affections of the bowels, and also in 
chronic vomiting. Topically, it is employed as an anodyne in 
neuralgia, and in various forms of cutaneous disease (fSj—iij to 
water Oj-iss), notably urticaria and prurigo. 

The dose of the officinal acid is gtt. i-ij, to be repeated and 
gradually increased by a drop till some effect is perceptible. 
When it is taken for a length of time, care should be observed to 
have the medicine, as renewed, of uniform strength ; and it is 
best, in using a fresh sample, to return to the minimum dose. 

Potassii Cyanidum (Potassium Cyanide, KCN), is used as a 
substitute for hydrocyanic acid, and has the advantage of being 
a more uniform chemical product, and less liable to undergo 
decomposition. It is made by heating together potassium ferro- 
cyanide and potassium carbonate, and occurs in white, opaque, 
amorphous pieces, having a sharp, somewhat alkaline and bitter- 
almond taste, and an alkaline reaction ; its solution yields the 
odor of hydrocyanic acid when exposed to the air. It is deli- 
quescent, very soluble in water, and sparingly so in alcohol. Its 
medicinal and poisonous effects are the same as those of hydro- 
cyanic acid. 

Dose, gr. \ in f§ss of distilled water, to be repeated and in- 
creased. The addition of a few drops of some vegetable acid 
frees the hydrocyanic acid, and the same effect is produced by 
the acids of the stomach. Lethal effects may be obtained by 
prolonged contact with the skin. It is also irritant, and will 
produce an eschar. As much as gr. iij have been taken by an 
adult without fatal results (Taylor *). 

Oleum Amygdala Amar^e (Oil of Bitter Almond') contains 
hydrocyanic acid, and may be used for the same purposes. It is 
obtained by distillation from the kernel of the fruit of Amygdalus 
communis, variety Amara (Nat. Ord. Rosacea^), and is of a 
yellowish color, with a bitter, acrid, burning taste, and the 
peculiar odor of the bitter almond, which is different from that 
of hydrocyanic acid. It is heavier than water, slightly soluble 
in it, and soluble in alcohol and ether. It contains benzoic 
aldehyde and hydrocyanic acid, which are developed from a 

* Guy's Hospital Reports, xiil, 1868. 



300 MATERIA MEDICA NEUROTICS. 

principle termed amygdalin, and water, under the influence of an 
albuminous ferment termed emulsin : thus, amygdalin (C 20 H 17 - 
NOn) + water (2H 2 0) = benzoic aldehyde :C 7 H 5 OH) + HCN 
+ glucose (2C 6 H 12 6 ). The effects of this oil upon the 
system are closely analogous to those of hydrocyanic acid, and 
its strength is about four times that of the diluted officinal acid. 
Dose, for internal use, gtt. J— } in emulsion ; as an external 
application, gtt. j to a f§j of menstruum. Bitter Almond Water 
(aqua amygdalae amarse) is used as a vehicle for narcotic medi- 
cines containing one part of the oil dissolved in 999 parts of dis- 
tilled water. Dose, fgss. 

Syrupus Amygdala {Syrup of Almond), made from both the 
sweet and bitter almonds, is slightly impregnated with the 
virtues of hydrocyanic acid, and is a pleasant vehicle for cough 
mixtures. 

AMYL NITRIS AMYL NITRITE. 

Amyl nitrite (C 5 H n N0 2 ) is prepared by heating one part of 
strong nitric acid with two parts of rectified fusel oil (amylic 
alcohol or amyl hydrate — C 5 H n HO) until it approaches boiling, 
when the fire is removed. After the violent reaction has sub- 
sided, heat is again carefully applied. The distillate obtained 
below 212 F. is rectified over potassium carbonate, with the 
precaution to collect only that portion distilling between 202 
and 206 F. It is a clear amber-colored, volatile, inflammable 
liquid, of sp. gr. 0.872 to 0.874, boiling at about 205 ° F., giving 
off an orange-colored vapor. It has an odor and taste like that 
of ripe pears. It is insoluble in water, but soluble in all propor- 
tions in alcohol, ether and chloroform. Amyl nitrite should be 
kept in small glass-stoppered bottles, in a dark and cool place. 

Effects and Uses. — The following account is based on the inves- 
tigations of H. C. Wood,* Amez-Drozand,f and Lauder Brun- 
ton{. When amyl nitrite is inhaled, it causes flushing of the head 
and face, a feeling of oppression in the head, with vertigo, 
excited cardiac action, diminished blood pressure, marked 
dilatation of the arterial system, from paresis of the muscular coat 



* Am. J. Med. Set., July, 187 1, p. 39. 

f Arch, de Phys. Norm, et Pathol., v, 1863, 467. 

\ Journ. of Anat. and Physiol., V, p. 92. 



SPINANTS AMYL NITRITE. 3OI 

of the vessels, due to direct action of the drug (Lauder Brunton, 
loc. cit), lowering of temperature, retarded respiratory move- 
ments, which tend to become slower as the administration is 
pushed, and eventually are extinguished, from a paralyzing influ- 
ence on the respiratory centre. At the same time there is com- 
plete motor paralysis. Consciousness is not destroyed, unless a 
condition approaching death is produced. 

The violent action of the heart is due, probably, to depression 
of the cardiac inhibitory nerves. On the reflex function and 
spinal motor centres, amyl nitrite acts as a powerful paralyzer. 
It also lessens the functional activity of the muscles and nerves. 
Dilatation of the vessels of the retina has been observed by the 
ophthalmoscope. Amyl nitrite has the property of diminishing 
the oxidizing function of the red blood-corpuscles, uniting with 
them to form a new compound, methemoglobin, which is not as 
readily deoxidized as hemoglobin, but which may be again con- 
verted into the latter by reducing agents. Whether inhaled or 
administered internally, amyl nitrite increases to a marked degree 
both the quantity of urine passed and the amount of' uric acid 
and urea eliminated (Mya). Sugar has been found in the urine 
of rabbits to which the drug had been administered by hypoder- 
mic injection. 

It has been employed to rouse the system in cases of syncope 
and prostration, as an antidote to chloroform poisoning, and has 
been found efficacious in relieving the pain of angina pectoris, 
eclampsia parturientium, and other convulsive diseases, and 
Frazer* has recently called attention to the value of the inhala- 
tion of amyl nitrite to relieve the dyspnoea of asthma. In uraemic 
asthma especially are the good effects of an inhalation of the drug 
seen, the relief being very speedy, the quantity of urine much 
augmented, and the amount of albumen lessened, at the same 
time the cedema decidedly subsides (Ringwood ; Rossbach ; 
Mya). In dyspnoea due to cardiac failure, it is also beneficial. 
In dysmenorrhea of the so-called congestive form, it often proves 
serviceable. The inhalation of the vapor of the nitrite has also 
been found efficacious in arresting epileptic seizures, when their 
approach is indicated by the aura epileptica; and also in tetanus, 

* Am. J. M. Sci., Oct., 1887, p. 393. 



302 MATERIA MEDICA NEUROTICS. 

nausea marina, and strychnine poisoning. Dr. Macdonald* re- 
commends its use in gout, on account of the rapid elimination of 
uric acid which it causes. 

It is indicated in all conditions where there is a high degree 
of tension of the arterioles. 



The following drugs, although not officinal, are deserving of 
notice in connection with amyl nitrite. 

N itroglycerinum {Nitroglycerin — Trinitroglycerin — Glonoin 
(C ;i H 5 (N0 3 )3) is made by the action of sulphuric and nitric acids 
on glycerin, and occurs as a colorless or pale yellowish, oily 
liquid, with a sp. gr. 1.600 ; it crystallizes in long needles if kept 
for some time at the temperature of 32 F.; is nearly insoluble 
in water, but readily soluble in alcohol and ether. It is without 
odor. Nitroglycerin forms the basis of various explosives, as 
dynamite, giant powder, etc., and will itself explode with great 
violence if heated in a closed vessel or if forcibly percussed. 
Hayf has made some experiments which seem to show that 
nitroglycerin is a nitrate of glyceryl. 

Physiological Effects. — The effects of nitroglycerin resemble 
those of amyl nitrite and the other nitrites, but are more per- 
sistent. Hay (loc. cit) considers their similarity of action to 
be due to the nitrous radical contained in each, which is the 
view expressed by a recent experimenter (Armstrong J) and it 
appears to be substantially correct. When inhaled it causes 
flushing of the face and headache. Given internally, in small 
doses § (gr. yto)> ^ causes very great acceleration of the pulse 
and respiration, diminished blood-pressure, flushed face, a feeling 
of tension and throbbing, and severe headache, pharyngeal con- 
striction, diaphoresis, all lasting some hours. After larger doses 
all these symptoms are present to a greater degree ; there is 
gradual paralysis of reflex and voluntary motions, loss of sen- 
sation, and finally death from paralysis of respiration. Injected 
into cats Brunton || found that it produced paralysis without 

* Brit, Med. Journ., 1885, p. 1039. j- The Practitioner, xxx, p. 422. 

%Med. Times, Feb., 1888, p. 260. 

$ British Med. Journal, March, 1880, vol. 1, p. 406, article on nitro-glycerine. 
■J St. Bartholomew's Hospital Reports, xii, 1 876, p. 140. 



SPINANTS AMYL NITRITE. 3O3 

tetanus, and in addition it poisoned the muscles. On the motor 
nerves its action is uncertain. It paralyzed the cord before the 
ganglia at the base of the brain ; slowed the action of the heart 
directly, and reduced the blood-pressure. It is decomposed by 
the alkalies in the blood, the greater portion of the nitric acid 
of the compound being converted into nitrous acid and com- 
bining with alkaline bases, forming nitrites which lessen the 
oxidizing power of the red corpuscles and cause both arterial 
and venous blood to assume a dark chocolate hue. Nitroglycerin 
is a muscle poison, and when applied directly to the heart of the 
frog causes paralysis of that organ. Prof. Rossbach, of Jena, finds 
that it greatly increases both the quantity of urine and the 
amount of uric acid and urea present. 

Three fatal cases * are recorded, but the amount is not given. 

Medicinal Uses. — Nitroglycerin is used to relieve the tension 
of the vessels, as in angina pectoris, in which disease pre- 
eminently there is a high arterial tension. If taken at the 
beginning of an attack of asthma (especially if due to emphy- 
sema), it will frequently give good results (Korczynski). In 
uraemic asthma it is often useful, but if the symptoms are urgent, 
it is best to let the patient inhale amyl nitrite until the danger is 
abated, after which nitroglycerin should be administered. 

In puerperal eclampsia it has been of great service, and has 
also been recommended in cardiac dyspnoea, due to cardiac failure, 
and in weak heart, or where fatty degeneration of the cardiac 
muscle is taking place ; although many prefer the use of amyl 
or other nitrite in these cases. It is also useful in Bright's 
disease, both in the acute and chronic forms. It sometimes 
affords relief in neuralgias, in gastralgia and in hepatic colic, and 
has been found useful to arrest vomiting in sea-sickness. It has 
also been used with success in the cold stage of intermittent 
fevers, as by dilating the vessels it will frequently abort or cut 
short the attack. It is best given in a one per cent, solution in 
alcohol, of which the dose is t^ss-x. It is best to begin with a 
small dose and gradually increase it. 

Potassium Nitrite and Sodium Nitrite have been introduced 
into practice as similar in effects and uses to amyl nitrite and 

* Woodman and Tidy, 1882, p. 464. 



304 MATERIA MEDICA NEUROTICS. 

nitroglycerin, and this similarity has recently been corroborated 
by Armstrong (loc. cit.) and Reichert * in some experiments on 
the pharmacology of the nitrites. Dr. Matthew Hayf believes 
the sodium salt to be as active and reliable in angina pectoris as 
either of the above drugs, and prefers it, because when used in 
medicinal doses, it does not cause the headache, giddiness or 
even partial collapse, which are sometimes seen after their use. 
Dose, gr. iij-v or more, in aqueous solution. 

GELSEMIUM. 

Gelsemium sempervirens, Yellow or Carolina Jasmine {Nat. 
Ord. Loganiaceae), is a beautiful climbing plant of our southern 
States, with a twining, smooth, and shining stem, perennial, dark- 
green leaves, and beautiful, very fragrant flowers, of a deep-yellow 
color. The rhizome and rootlets are officinal. The true root 



Fig. 25. 




GELSEMIUM SEMrERVIRENS. 



is hard and woody, slightly undulated in outline, sparingly 
branched, externally of a pale-brown color, smooth, and fur- 
nished with a thin scurfy cuticle, slightly cracked longitudinally. 
The stem is rougher externally, and is distinguished from the 
root by a small central cavity, representing the pith. The stem 
should be rejected. The root has a bitter and pleasant flavor, 
and an odor somewhat between that of senega and green tea. 



* Am. Jour. Med. Sci., Vol. 80, p. 158. 
I Practitioner, March, 1 883. 



SPINANTS GELSEMIUM. 305 

It contains an alkaloid termed gelsemine, combined with an add 
called gelseminic, both discovered by Wormley* (not identical 
with aesculin), a volatile oil, an acrid resin, etc. The alkaloid, 
which represents chiefly the physiological action of the drug, 
though Ottf has shown gelseminic acid, gr. j— *4 injected into 
cats to be a fatal tetanizer, is a powerful poison, an amount of 
gelsemium estimated to contain gr. ^ of gelsemine having proved 
fatal to an adult woman. 

Effects and Uses. — The action of gelsemium has been investi- 
gated and described by the following observers, viz., Bartholow,J 
Ott (loc. cit), Ringer and Murrell§ and Holmes,|| as follows : Gel- 
semium in moderate doses, causes languor, dizziness, disordered 
vision and frontal pain, but hardly affects the circulation. Large 
doses diminish the pulse and blood-pressure by direct action 
on the heart, the temperature of the body, lessen respiration, 
and dilate the pupils, with little or no nauseating or purgative 
effect, nor does it exhibit any characteristic influence upon the 
brain. Ott's (loc. cit.) conclusions are these, viz., that gelsemine 
has no action on the motor or sensory nerves, nor on muscular 
contractility, which is in accord with those of Bartholow (loc. 
cit.) ; the last observer concludes that its paralyzing influence is 
due to a direct action on the motor and sensory centres of the 
cord. It appears to slow the heart by direct action, and it 
destroys life by paralysis of respiration. By summing up its 
action, after examining the effects of lethal doses, and the results 
of experiments, we can deduce the fact that gelsemium is a 
powerful depressant, not only of the motor, but also of the 
sensory centres, in the spinal cord. 

In overdoses, it has rapidly produced death, with great mus- 
cular relaxation, want of coordination in the movements, 
difficulty of speech, double vision, dilatation of the pupils, failure 
of the pulse and respiration, coldness of the surface, and finally 
unconsciousness preceding death. Ott^f has collected six cases of 
fatal poisoning by Gelsemium, the minimum dose being f$j of the 
fluid extract. 

* Am. Journ. of Pharm., Jan., 1870, and July, 1882. 
| Phila. Med. Times, V. July, 1875, and March 31, 1887. 

% The Practitioner, v, p. 200. || Annuaire de Therap., 1877, p. 41. 

\ The Lancet, Jan. 15th, 1876. \ Phila. Med. Times, Vol. v, p. 689. 

20 



306 materia medica NEUROTICS. 

It has been used in fevers, inflammations, essential spasmodic 
affections, as tetanus, and as a hypnotic in delirium tremens 
and other forms of morbid wakefulness, and as an anodyne 
in odontalgia and trifacial neuralgia. As a calmative in acute 
mania it has been given in full doses. Bartholow recommends 
gelsemium in acute inflammations of the lungs and pleura, espe- 
cially in pneumonia and pleurisy. He gives the fluid extract 
^v-x every two hours " to maintain a constant effect within the 
limits of safety." Bulkley * advises the internal use of tincture 
of gelsemium gtt. x, repeated, to relieve the itching of eczema 
and prurigo. The tincture of gelsemium is the form which has 
been heretofore employed, in the dose of r^v-xx; but the fluid 
extract should be preferred, dose, t^v-x; f5j of this has proved 
fatal. 

WOORARA. 

This solution, termed also woorari, woorali, and curare, has 
long been known as a powerful poison prepared by the Indians, 
in South America, and of late years has been employed as a 
medicine. Its source is unsettled, but it is generally considered 
to be an extract from the bark of Strychnos toxifera and other 
species of Strychnos. It is brought from the banks of the Ori- 
noco, and occurs in the form of dark-brown or grayish lumps or 
powder, of an intensely bitter taste, and, when triturated, of a 
powerful odor. An alkaloid termed curarine (C 18 H 35 N) has 
been extracted from woorara, which is said to exist as a sul- 
phate (Sachs). Recently (1886) another alkaloid termed curine 
has been discovered by Bohm. 

Effects and Uses. — Woorara, topically applied, is an irritant. 
It is ranked with the motor depressants, and is considered to 
destroy life by paralysis, more or less rapid, of the respiratory 
muscles. A peculiarity of its action is that it is comparatively 
innocuous when taken by the stomach, being either not absorbed 
at all in this viscus, or so slowly as to allow of its elimination 
by the kidneys before dangerous accumulation in the blood. 
According to Lauder Brunton, on introduction into the stomach 
the absence of poisonous effects of curare is due, probably, to 
its being passed round the entero-hepatic circulation. Hence, 

* A 7 ". Y. Med.Journ., Jan., 1881. 



SPINANTS VIBURNUM. 307 

for therapeutic purposes, it must be employed either enderniic- 
ally to a blistered surface or by hypodermic injection. Woorara 
kills the intra-muscular motor nerve-endings without affecting 
the muscular irritability, and destroys the reflex function of the 
spinal cord : in other words, the paralysis induced by it is 
peripheral and not centric ; eventually, however, the paralyzing 
action of woorara extends to the nerve-trunks and centres. The 
cerebrum is only secondarily involved. Artificial respiration 
retards the poisonous effects of the drug. Woorara stimulates 
and then paralyzes the accelerator cardiac nerves. Other effects 
of woorara are elevation of temperature, increased nasal, salivary 
and intestinal secretions, and diabetic urine (in animals). The 
elimination of curarine has been distinctly shown to take place, 
in part, by the kidneys. 

Woorara, or curarine, is only applicable to the treatment of 
those affections which therapeutically require motor depress- 
ants to antagonize the disease process. Among the most promi- 
nent of these are tetanus and hydrophobia. In tetanus good 
results have been obtained from its use in large doses, while 
from hydrophobia there are two reported cases of recovery. It 
has also been employed in chorea and epilepsy. The dose 
of woorara is from y 1 ^- to |- of a grain. Of curarine, from gr. yj-g- 
to y^-Q, hypodermically. Caution must be enjoined, as the 
samples vary. 

VIBURNUM. 

Viburnum is the bark of Viburnum prunifolium, commonly 
known as the Sloe or Black Haw {Nat. Ord. Caprifoliaceae), a 
small tree growing in thickets in the southern and western 
States, with opposite, oval, obovate, sharply serrulate leaves 
about two inches long, and short, slightly marginal petioles. It 
has small white flowers in terminal cymes, appearing in May ; 
and small blue-black edible drupes containing a flatfish, smooth 
putamen. The bark is in thin pieces or quills of a purplish- 
brown color, with scattered warts and minute black dots ; col- 
lected from the old wood it is a grayish-brown, the thin corky 
layer easily removed from the green layer ; the inner surface is 
whitish and smooth ; it breaks with a short fracture ; is without 
smell, and of a bitter, astringent taste (Stille and Maisch ; 



308 MATERIA MEDICA NEUROTICS. 

Maisch). It contains valerianic acid, a brown bitter resin, a 
greenish-yellow bitter principle {vibumin), tannin, etc. 

Effects and Uses. — The physiological effects of viburnum are 
not understood. It probably acts as a sedative to the spinal 
centres, especially those governing the uterine functions ; 
whether it influences the circulation or the blood supply to the 
uterus, or what action, if any, it has on the sympathetic gan- 
glionic system are questions for the future to determine. It is 
said that no disagreeable after-effects attend its use. Viburnum 
is highly recommended as a sedative in cases of threatened 
abortion,* whether accidental or due to the action of drugs, and 
is said to be especially serviceable where a tendency to abortion 
exists from habit. In these cases 5j may be given every two 
or three hours as long as the abortion is threatening. It is also 
recommended to allay the severity of after-pains, and is one of 
the numerous remedies which have been used for the relief of 
the vomiting of pregnancy. It has also been used with success 
in menorrhagia and metrorrhagia, depending on anaemia, debility 
or other systemic cause, and in menorrhagia accompanied with 
nervous symptoms appearing at the climacteric period. It has 
been given, too, in dysmenorrhceaf with profuse discharge, 
accompanied by a feeling of weight in the pelvis, and may be 
combined with other remedies in the treatment of neuralgic dys- 
menorrhcea. The fluid extract is officinal, the dose of which is 
f3ss-j. 

GRINDELIA. 

Grindelia is the leaves and flowering tops of the Grindelia 
robusta [Nat. Ord. Composite), an herbaceous perennial plant 
growing to the height of one or two feet, indigenous to the 
Pacific coast. It resembles the common sunflower in its general 
appearance, and contains vegetable wax, fixed and volatile oils, a 
greenish, soft, acid resin having the odor of the drug, an acid 
saponin-like body (grindelin), a trace of tannin, but no alkaloid 
(W. H. Clark J). 

Effects and Uses. — In large' doses, grindelia has a decided 

* Liverpool Med. and Surg. Journal, 1875, p. 41, J. H. Wilson. 

f " New Preparations," 1879, P- l 37- 

J American Jour, oj Pharmacy, Sept., 1888. 



SPINANTS SUMBUL. 3O9 

hypnotic effect, during which the pupils are dilated and reflex 
action, motion, and sensation are depressed. Buffington's* inves- 
tigations give the following results : the cardiac action is slowed 
by grindelia, through stimulation of its inhibitory centre while 
the local blood pressure is raised. The statement as to the 
slowing of the heart and reduction of blood pressure are con- 
firmed by Dobroklonsky.f The respiratory movements are 
increased in frequency by an action of the drug on that centre. 
It is eliminated by the kidneys, inducing a marked increase in 
the urinary flow and to a certain extent by the lungs. The state- 
ment in regard to its diuretic action is not confirmed by Dobrok- 
lonsky (loc. cit.), who affirms that it is feebler in this respect than 
digitalis. Grindelia is not actively toxic, though a lethal dose 
will destroy life by arrest of respiration. 

Grindelia is very serviceable in the treatment of asthma, espe- 
cially in the uncomplicated spasmodic form, but has also proved 
useful when complicated with bronchitis, etc. In many cases of 
hay asthma and hay fever it has proved of much benefit. It is 
useful in pertussis, and is also recommended in acute and chronic 
bronchitis and pneumonia. Dr. H. M. Fiske recommends its 
internal and local use in iritis. It has been used as an injection 
in vaginitis and as a local application in poisoning by rhus 
toxicodendron, the latter with varying results. The fluid extract 
is officinal, the dose of which is ^x-f5j. 

SUMBUL. * 

Sumbul is the root of the Ferula Sumbul {Nat. Ord. Umbelli- 
ferae), a perennial plant, growing to the height of eight feet, with 
large triangular, tripinnate radical leaves and a few small cauline 
leaves. It is a native of Turkestan and eastern Siberia. The 
root reaches us through Russia, and is met with in transverse 
slices from one to five inches in diameter and three-quarters to 
two inches thick. It is light, spongy, annulated, with a thin 
brownish bark and a whitish interior, with numerous dots of 
brown-yellow resin and irregular, easily separated fibres ; of a 
strong musk-like odor and a bitter balsamic taste. The root of 

* Am. Joitrn. Med. Sci., Jan., 1886. 

f These de St. Petersburg. Quoted by Bull. Gen. de Therap., cxi, 277. 



3IO MATERIA MEDICA ECCRITICS. 

the Dorema ammoniacum is sometimes flavored with sumbul, 
but may be distinguished from it by being firmer, denser, and of 
a yellow or reddish tint (Stille and Maisch). Sumbul root 
contains a volatile oil, a soft resin, angelic and valerianic acids 
(Maisch). The soft oleo-resin is soluble in ether, exists in the 
proportion of 9 to 1 00, and imparts to water the odor of musk 
(Remsch).* 

Effects and Uses. — The physiological effects of sumbul are not 
accurately known. It probably acts as a sedative to the brain 
and spinal cord. It was originally introduced into Russia as a 
remedy for cholera, and is still used there in asthenic dysentery 
and diarrhoea. In England it has been used in dysmenorrhea, 
hysteria, epilepsy, and various allied nervous disorders. Mr. 
Murawieff recommends it in chronic bronchitis in old and debili- 
tated patients, in humid asthma, atonic dyspepsia, hypochon- 
driasis and hysteria, and Phillips has seen it prove useful in 
chronic bronchitis and in certain stages of phthisis. He also 
recommends it in severe cases of facial, sciatic, or ovarian neu- 
ralgia, and in the restlessness of pregnancy. Boehm (Ziemssen's 
Cyclopedia) speaks favorably of it in delirium tremens. It is not 
much used in this country. The tincture may be given in doses 
of t%x-f5j. 



CLASS II. — ECCRITICS. 

ORDER I. EMETICS. 

Emetics (from 's/jJoj, I vomit) are medicines which are employed 
to promote vomiting ; when they are used merely to excite nausea, 
they are termed nauseants. When an emetic is administered, 
usually within fifteen or twenty minutes afterward a feeling of 
distress, relaxation and faintness is experienced, with coolness 
and moisture of the skin and a small, feeble, irregular pulse. 
These symptoms increase till the contents of the stomach are 
ejected. During the act of vomiting, the face becomes flushed, 
the pulse is full and frequent, and the temperature of the body 
is increased. After vomiting is over, the skin is moist, the pulse 

* Journ. de Pharm. et de Chimie, 4.ieme S er., 1 87 1, p. 320. 



EMETICS. 311 

soft and feeble, the patient becomes languid and drowsy, and, 
under peculiar circumstances, alarming and even fatal syncope 
has been induced. Emetics act either directly on the centres of 
the medulla which govern the act of vomiting, or by the local 
irritation they produce, which, being conveyed to the centre by 
filaments of the pneumogastric nerve, produces vomiting in a 
reflex manner. In the former case, vomiting is produced by the 
drug, no matter in what manner it enters the system, and it is 
therefore called a systemic emetic ; in the latter, vomiting is only 
produced by the introduction of the substance into the stomach, 
and it is hence called a local emetic. Dr. Marshall Hall gives the 
following summary of the mechanism of vomiting: " During the 
act of vomiting, 1, the larynx is closed ; 2, the cardia is opened ; 
and 3, all the muscles of expiration are called into action ; but, 
4, actual expiration being prevented by the closure of the larynx, 
the force of the effort is expended upon the stomach, the cardia 
being open, and vomiting is effected." 

Susceptibility to the action of emetics differs in different indi- 
viduals and in different diseases. In fevers, and where gastric 
irritation is present, their influence is increased; and, on the other 
hand, when the brain is oppressed by disease or by narcotic medi- 
cines, the stomach is exceedingly insensible to their action. 

Emetics are employed therapeutically — 1, to evacuate the 
stomach, for the purpose of removing poisons, undigested food, 
etc. ; and, with this view, the emetics should be selected which 
occasion least nausea and distress ; 2, to expel foreign bodies lodged 
in the throat or oesophagus ; 3, to excite nausea, and thereby 
depress the vascular and muscular systems ; 4, to relieve spasm, 
as in' spasmodic croup; 5, to promote secretion and excretion, 
etc. ; and, 6, sometimes to break up a train of morbid associations, 
by giving a shock to the system, as in the forming stages of 
certain fevers, as typhus and scarlatina, and of delirium tremens. 
They are improper where the effort of vomiting is liable to 
increase any existing pathological conditions, as in congestion of 
the brain, pregnancy, hernia, etc., or where such debility is present 
that the depressing effects might prove fatal, as in the last stages 
of membranous croup. The act of emesis is promoted by the free 
use of tepid drinks ; excessive vomiting may be checked by 
demulcents, opiates, counter-irritation to the stomach, etc. 



312 



MATERIA MEDICA ECCRITICS. 



VEGETABLE EMETICS. 
IPECACUANHA IPECAC. 

Ipecacuanha is the root of Cephaelis Ipecacuanha (Nat. Ord. 
Rubiaceae), a small shrubby perennial plant of Brazil, where it grows 
to the height of about five or six inches. The roots, as met with in 
the shops, are in pieces about the size of a quill, several inches long, 
of an irregular, twisted, contorted shape, with numerous circular 



Fig. 26. 




CEPHAELIS IPECACUANHA. <Z, b, ROOT ; a, ANNULATED. 



rings or rugae, from which they have been termed annulated. When 
broken, they are seen to consist of two distinct parts — a thin ligneous 
axis or centre, which is nearly inert, and a thick cortical layer, which 
has an herbaceous, acrid, rather bitter taste and a slightly nauseous 
odor. A distinction is made of black, red and gray ipecacuanha, 
from differences in the color of the epidermis ; but they are all 
derived from the same plant, and are the same in properties and 
composition. The black is the most common variety in our mar- 



EMETICS IPECAC. 3 I 3 

ket. The powder is of a light grayish-fawn color, and has a 
peculiar nauseous odor, which in some persons excites violent 
sneezing, in others, dyspncea. Ipecacuanha imparts its virtues 
to both water and alcohol, but they are injured by decoction. 
Its emetic property depends on the presence of an alkaloid, 
termed emetine (C 30 H4 N 2 O 5 ) (Kunz*), which exists in combina- 
tion with ipecacuanhic acid. Emetine is a whitish, inodorous, 
slightly bitter substance, sparingly soluble in water and ether, 
and very soluble in concentrated alcohol and chloroform. It 
produces vomiting in the dose of gr. J^, and in overdoses may 
occasion dangerous and even fatal symptoms. Occasionally a 
sophisticated root, that of Psychotria emetica, derived from New 
Granada, is found in the markets ; this is not annulated l but 
longitudinally striated, and contains less than half the quantity 
of the emetine found in the genuine root (1% per cent.). 

Physiological Effects. — Locally, powdered ipecac is an irritant 
to raw surfaces and to the mucous membranes, causing violent 
sneezing, etc. When rubbed into the sound skin it causes pus- 
tulation and even ulceration. Nervous system : it stimulates 
the centre of the medulla oblongata which presides over the 
act of vomiting, and somewhat diminishes the reflex activity of 
the cord. The following observers, viz. : D'Ornellas,f Phillips,! 
and Duckworth, § ascertained that emetine, in animals, always 
caused vomiting, given either by the stomach or subcutaneously. 
D'Ornellas {loc. cit.) and, Duckworth (loc. cit.) found, too, that 
when the vagi were divided in the neck the alkaloid was power- 
less as an emetic. Toxic doses (in animals) generally destroy 
life by paralyzing the respiratory centres, the nerves probably 
remaining unaffected. Circulation : moderate doses probably 
do not affect the circulation ; very large doses injected into the 
jugular vein of dogs have killed by cardiac paralysis. Temper- 
ature : in the mouth and on the surface the temperature falls in 
cases of emetine poisoning, but in the intestines it rises (from the 
irritant action of the poison). Secretion : repeated small doses 

* Arch, der Pharmacie, 1 887, p. 461. 

f Bull Gen. de Therap., LXXXIV, pp. 193, 244, 348: Du Vomissement, etc. 
\ Practitioner, London, III, p. 276. " On the action and uses of ipecacuanha." 
\ Ibid. ,Yo\. v, p. 218, and Vol. vn, p. 91. "Observations upon the action of 
ipecacuanha " etc. 



3 14 MATERIA MEDICA ECCRITICS. 

relax the skin and increase the perspiration, saliva and the 
bronchial and gastric mucus. Rutherford states that it has the 
power of stimulating the secreting apparatus of the liver (in 
dogs), and that the consequent augmented secretion of bile is 
normal in composition as regards the biliary matters proper. It 
also increases the secretion of intestinal mucus. Gastrointes- 
tinal tract: it is an irritant to the stomach, producing vomiting 
by local irritation as well as by direct action on the medulla. 
Elimination takes place by the gastro-intestinal mucous mem- 
brane, and also by other secretions. 

Post-mortem appearances : after death from ipecac, the stomach 
and small intestines are found intensely congested, as are the 
lungs with patches of hepatization ; sometimes, however, the 
lungs are exsanguine. 

Medicinal Uses. — In full doses, ipecacuanha is a mild and cer- 
tain emetic, well adapted to the treatment of spasmodic croup 
and acute bronchitis in children, and to all cases where a simple 
evacuation of the stomach is desired. In smaller doses it 
produces nausea, depression of the pulse, expectoration and 
diaphoresis, and with these views it is employed in the treat- 
ment of pulmonary affections, dysentery, and inflammatory dis- 
orders generally. In still smaller doses it is useful as a tonic 
and stomachic. 

Ipecacuanha was first introduced as a remedy in dysentery, 
and, after being for a time laid aside, has been again used with 
marked success. It is particularly of value in epidemic dysen- 
tery, and in India is used in very large doses in this affection, 
as much as 5ij being sometimes given every few hours. The 
editor has seen much good follow its use in acute dysentery of 
sporadic kind, especially when occurring in puerperal women, 
given in doses of gr. xv-xx combined with opium every three 
or four hours. If no effect is produced by the ipecac-treatment 
of dysentery in two days, it is best to abandon it (H. M.). It 
is also used with advantage in the vomiting of sick headache, 
and will sometimes, when given in small doses, frequently 
repeated, arrest the nausea and even the vomiting of pregnancy 
(Fuller*). The wine or fluid extract (in drop doses) is best for 

* Lancet, London, Dec. 4th, 1869, p, 268. 



EMETICS SANGUINARIA. 3 I 5 

this purpose. Given in pills containing gr. %-% before meals, 
it is of service in dyspepsia accompanied by deficiency of gastric 
and biliary secretions. As it stimulates the secretory apparatus 
of the stomach and liver, the rationale is obvious. 

Administration. — Dose, as an emetic, gr. xv-xx ; as a nanseant, 
gr. ss-ij, three or four times a day ; as an expectorant or diapho- 
retic, gr. y^—y^y repeated ; as a tonic, gr. -^, repeated. The fluid 
extract is used as an addendum to expectorant and diaphoretic 
mixtures, and in bronchitis is advantageously combined with the 
syrup of wild cherry and morphine (B). As an emetic, the dose 
is fSss-j ; the wine (yinum ipecacuanha?) contains fluid extract 7 
parts in stronger white wine 93 parts ; dose, as an emetic, f oss-j ; 
fluid extract, 5 parts, mixed with simple syrup, 95 parts, makes 
syrupus ipecacuanha?, an excellent preparation for children — f§j 
containing gr. xxx of ipecacuanha ; for a child a year or two old, 
f5ss-j may be given as an emetic, and gtt. v-xx as an expectorant. 
Pidvis ipecacuanlia? et opii (formerly called pulvis ipecacuanha? com- 
positus, or Dover s powder) contains powdered ipecac and opium 
each gr. j, sugar of milk gr. viij (see Opium, p. 82) ; a tincture of 
ipecac and opium is also officinal (see p. 83). Troches of ipecacu- 
anha (contain also sugar, tragacanth, and syrup of orange-peel), 
each troche contains ipecac gr. y^. Troches of mor plane and 
ipecac each contain morphine sulphate gr. ^-, ipecac gr. -^-, with 
sugar, oil of gaultheria and mucilage of tragacanth. 

SANGUINARIA. 

The rhizome of Sanguinaria canadensis, or Bloodroot (Nat. 
Ord. Papaveraceae), a small indigenous plant, with radical, cor- 
date, lobate leaves and a handsome white eight-petaled flower, 
which appears in early spring, is usually classed with emetics. 
When dried it is in flattened pieces, much wrinkled and contorted, 
of a reddish-brown color, with a faint narcotic odor and bitterish, 
very acrid taste. It yields its virtues to water and alcohol, and 
loses them rapidly by keeping. An alkaloid, sanguinarine 
(C 19 H 17 N0 4 ), has been obtained from it which possesses the prop- 
erties of the root. 

Effects and Uses. — Bloodroot is an acrid emetic, and, in large 
doses, an acro-narcotic poison. Locally, it acts as an irritant, and 
upon fungous surfaces, as an escharotic. When inhaled, the 



3i6 



MATERIA MEDICA ECCRITICS. 



powder causes violent sneezing. In large doses it causes collapse, 
dilated pupil, and sometimes convulsions of spinal origin, and 
diminishes reflex activity. After nauseating doses the pulse and 
arterial pressure are increased, but when enough is taken to pro- 



Fig. 27. 




SANGUINARIA CANADENSIS. 



duce vomiting the pulse is slow and irregular and the arterial 
tension is lowered. After poisonous doses the respiration 
becomes shallow and slower, and death takes place from asphyxia, 
due to paralysis of the respiratory centre. 






EMETICS APOMORPHINE HYDROCHLORATE. 317 

Sanguinaria* produces salivation and increases the secretion -of 
the gastric mucous membrane. It stimulates the liver and intes- 
tinal glands, increasing the secretion of bile, but at the same time 
rendering it more watery (Rutherford). It is an active systemic 
emetic, causing much depression and irritation of the mucous 
membrane. It is not much used as an emetic, but is occasionally 
employed with this view in croup and diphtheria, or as an expec- 
torant in pulmonary affections. In duodenal catarrh and second- 
ary catarrhal jaundice it has been used with advantage. It has 
also been used as an emmenagogue in amenorrhcea. Dose, as 
an emetic, gr. x-xx, in pill. Tincture — dose as an emetic, f5nj or 
iv; as an expectorant, f^v-xxx. The vinegar (acetum) contains 
ten per cent, by weight of the powdered drug. The fluid extract 
should be used with care, as it is a powerful preparation ; dose, 
as a nauseant, ^ij-v; as an emetic, ^xv-f5j. 

APOMORPHINE HYDROCHLORAS APOMORPHINE HYDROCHLORATE. 

Apomorphine (C 17 H 17 N0 2 ) is an artificial alkaloidal substance 
obtained by heating morphine with hydrochloric acid under 
pressure, the acid subtracting one molecule of water from a 
molecule of morphine, and leaving apomorphine (C 17 H 19 N0 3 = 
H 2 + C 17 H 17 N0 2 ). When apomorphine is treated with hydro- 
chloric acid it combines to form the officinal salt. When pure 
it is a white powder, but it absorbs moisture readily, becoming 
green, which change, however, is said not to impair its thera- 
peutic properties. 

Physiological Action. — Given to animals in large doses, it at 
first stimulates the nerve centres and afterward paralyzes them. 
Convulsions are produced, but their origin is not precisely 
determined, and it is a poison to the muscular system. f Small 
doses increase the cardiac action and elevate the pressure, 
but when large doses are taken, the cardiac movements are 
probably slowed and the pressure diminished. According to 
Reichert (loc. cit.), it quickens the heart's beats by stimulation 
of its accelerator fibres, and slows it by a direct depressing 
• 

* For the details of a complete investigation of the action of Sanguinaria, consult 
Am. J. M. Sci., Oct., 1876, p. 346, by R. M. Smith, M. d. 

f Phila. Med. Times, Dec, 1879, E. T. Reichert. " Physiolog. Action of Apomor- 
phine hydrochlorate." 



3 l8 MATERIA MEDICA ECCRITICS. 

influence on its muscular substance. Very large doses may 
have a decided sedative action on the circulation (in man), and 
even induce syncope. Large doses at first increase the number 
of the respiratory movements, but afterward diminish them. 
A poisonous dose destroys life by asphyxia, death being due to 
the action of the drug on the respiratory centre. Apomorphine 
is chiefly of interest therapeutically on account of the emesis 
which follows its administration, to which attention was first 
called, we believe, by Dr. S. J. Geef. It is a prompt and effi- 
cient systemic emetic, causing vomiting within a half hour after 
it is taken, which is repeated two or three times at intervals of 
about fifteen minutes, and is attended by slight nausea and 
usually little or no depression. 

Medicinal Uses. — Apomorphine may be used as an emetic 
hypodermically or by the stomach, in cases of narcotic poison- 
ins: or where it is desirable to evacuate the contents of the 
stomach promptly. It has also been used as an expectorant in 
both acute and chronic bronchitis, and in suffocative catarrh of 
infants. Trousseau recommends it in hemoptysis. Dose of the 
hydrochlorate (the same as that of the pure drug), gr. -^ hypo- 
dermically, or -§■ or perhaps \ by the stomach. It should be 
given cautiously, on account of the depression which occasion- 
ally accompanies its action. 

Sinapis {Mustard). The powdered seed of Sinapis nigra 
and Sinapis alba (Nat. Ord. Cruciferae), in doses of from a tea- 
spoonful to a tablespoonful, are very useful emetics, particularly 
in atonic conditions of the stomach. 

Tobacco and Lobelia act as emetics in large doses, but their 
employment is attended with danger, owing to the great pros- 
tration which they produce (see pp. 292 ; 294). Squill also 
possesses emetic powers, but it is too irritating for use in this 
respect. 

MINERAL EMETICS. 

Tartar Emetic. Dose, gr. j-ij (see p. 243). 
Zinc Sulphate. Dose, gr. x-xx (see p. 197). 
Copper Sulphate. Dose, gr. iij-v (see p. 196). 

* St. Barthol. Hosp. Reports, v, 215. 



CATHARTICS. 3I9 

Alum. Dose, a teaspoonful (see p. 204). 
Yellow Mercurial Subsulphate or Turpeth Mineral. 
Dose, gr. ij-v (see Mercuric Preparations). 



ORDER II. — CATHARTICS. 

Cathartics (from xadalpm, I purge), termed also purgatives, are 
medicines which produce evacuations from the bowels. Some 
operate by increasing the peristaltic motion of the intestines ; 
others stimulate the mucous follicles and exhalants, and occasion 
watery evacuations, whence they are termed hydragognes. The 
more violent of the hydragogues, if given in overdoses, produce 
inflammation of the alimentary canal, characterized by violent 
vomiting and purging, abdominal pain and tenderness, cold 
extremities and sinking pulse. From their activity they are 
denominated drastics. Different cathartics affect different parts 
of the alimentary canal unequally, some acting more particularly 
on the upper portion, some on the lower, and others affecting 
all parts equally. 

Cathartics may be arranged in five groups : 1 . Laxatives, which 
gently evacuate the contents of the bowels, without causing any 
obvious irritation or affecting the general system. 2. Saline 
cathartics, which increase both the peristaltic action of the bowels 
and the effusion of fluids from the mucous surface, but are 
devoid of any excitant action on the general system, and are 
therefore adapted to the treatment of febrile and inflammatory 
cases, or where, from any cause, it is desirable to deplete the 
vessels of the intestines by the abstraction of water. 3. Mild 
acrid carthartics, which are acrid, but not sufficiently violent in 
their local action to cause inflammation. 4. Drastics, comprising 
the more powerful and irritating cathartics, which, in large doses, 
act as acrid poisons. 5. Mercurial cathartics. 

Cathartics are employed therapeutically — 1. To evacuate the 
bowels in constipation, and remove noxious matters, as retained 
feces, undigested food, morbid secretions, worms, poisons, etc. 
2. To depurate the blood, as in typhus fever, uraemia, etc. 3. 
To relieve inflammation, congestion and plethora, by the deple- 
tion of the blood vessels, which results from increased secretion 



320 MATERIA MEDICA ECCRITICS. 

and exhalation from the gastro-intestinal canal. 4. To promote 
absorption. 5. To affect remote organs, particularly the brain, 
through the agency of revulsion and counter-irritation. 6. To 
stimulate the secretion of the liver and pancreas, by irritating 
the orifice of the ductus communis choledochus. 7. In the 
treatment of diarrhoea. 8. To relieve spasms of the bowels. 9. 
To restore the catamenia, by the irritating influence which they 
exert on the pelvic vessels. The more active cathartics are 
contra-indicated in cases of inflammation or ulceration of the 
gastro-intestinal mucous membrane, peritonitis, the advanced 
stages of typhoid fever, pregnancy, etc. 

The operation of cathartics is promoted by the addition of 
small doses of emetics and of the bitters. By combining those 
which act upon different portions of the alimentary canal, their 
operation is rendered less irritant, without any diminution of 
purgative efficiency. The griping and nauseating tendency of 
the drastic cathartics may be corrected by the addition of aro- 
matics ; carbonic acid water is a grateful vehicle for adminis- 
tering the saline preparations. Cathartics operate most speedily 
and favorably when given on an empty stomach, and suscepti- 
bility to their action is diminished during sleep, and increased 
by exercise. Mild diluent beverages promote their operation. 
In the event of hypercatharsis, opium should be administered 
by the mouth or the rectum. 

LAXATIVES. 

Several articles of diet have a laxative operation on the bowels, 
and are useful in cases of habitual costiveness, as most of the ripe 
and dried fruits — particularly the tamarind, peach, apple, raisin, 
fig (Jicus), and prune (prunum) — West India molasses, honey, 
bran, cracked wheat, Indian meal, and oatmeal. 

The following medicinal substances are usually arranged under 
the head of laxatives, and are employed in cases where we wish 
to open the bowels with the least possible irritation, — as in chil- 
dren and pregnant women, in inflammation or surgical opera- 
tions about the abdomen and pelvis, in typhoid fever, hernia, 
piles, and affections of the rectum or womb. 



CATHARTICS MANNA. 32 1 

TAMARINDUS TAMARIND. 

This is the preserved pulp of the fruit of Tamarindus 
indica {Nat. Ord. Leguminosae), a large tree of the East Indies, 
cultivated extensively also in the tropical portions of America. 
It comes to the United States chiefly from the West Indies. 
The preserved pods, as found in the shops, consist of a dark- 
colored adhesive mass, formed of pulp, fragments of the pods, 
seeds and syrup, of a sweetish acidulous taste. They contain 
a good deal of citric acid, with some tartaric and a little malic 
acid. An infusion of the pulp sweetened, makes a pleasant 
refrigerant and laxative drink ; oss-j of the pulp is a good laxa- 
tive. It enters into the confection of senna. 

MANNA. 

Manna is the concrete saccharine exudation, in flakes, of 
Fraxinus Ornus and of Fraxinus rotundifolia {Nat. Ord. Olea- 
ceae), small trees of Sicily and southern Italy. It is obtained 
from incisions into the stems of the trees. The best kind is pro- 
duced during the height of the season, when the juice flows 
vigorously, and from the upper stems, where it is less fatty. It 
is called flake-manna or manna canmdata, and consists of pieces 
from one to six inches long, one to two inches wide, and from 
half an inch to an inch thick, of irregular form, but more or less 
stalactitic, hollowed out on one side (from the shape of the tree 
or substance on which they are concreted), of a white or yellow- 
ish-white color, an odor like that of honey, and a sweet, after- 
ward rather acrid, taste. A common manna, called common 
manna, or manna in sorts, is obtained from incisions later in the 
season, and from the lower stems. It occurs in small pieces, 
which seldom exceed an inch in length, and are softer, more 
viscid and darker than the flake-manna. A still inferior variety 
is termed fat manna, and consists of small, soft, viscid fragments, 
of a dirty yellowish-brown color mixed with a few pieces of the 
flake-manna. Manna is soluble in both water and alcohol, and 
contains a white crystalline, saccharine principle, termed mannit 
(C 6 H 14 6 ), not susceptible of the alcoholic fermentation (found 
also in mushrooms, the olive tree and other plants), fraxin (C 32 
H^Ojjo) some sugar, and a resin to which it probably owes most 
of its purgative effect. 
21 



322 MATERIA MEDIC A ECCRITICS. 

Effects and Uses. — In moderate doses manna is nutritive ; in 
larger, mildly laxative. It is given principally to children, to 
whom its sweet taste renders it acceptable ; and it is sometimes 
combined with the more active cathartics. It may be taken in 
substance, or dissolved in warm milk or water. Dose for an 
adult, oj-ij ; for children, 5j— iij. 

VIOLA TRICOLOR. 

Viola tricolor is the wild-grown flowering herb of Viola 
tricolor, Heartsease or Pansy (Nat. Ord. Violaceae), an annual or 
biennial herb, native of Europe and northern Asia, naturalized 
in the United States and cultivated in our gardens. The stem 
is nearly smooth, and grows to the height of one-half to one 
foot ; the leaves are alternate, petiolate, ovate or oblong, crenate, 
and have prominent pinnatifid stipules. The flowers are on 
long peduncles, and have the corolla partly yellowish, blue and 
purple. It is without smell, and has a bitter, subacrid taste. 
It contains mucilage, sugar, salicylic acid, a bitter principle, resin, 
etc. 

Effects and Uses. — Heartsease is a mild laxative, sometimes 
proving diuretic and diaphoretic. It is occasionally given as a 
mild laxative to children, but its use is generally restricted to 
cases of eczema, psoriasis, and pityriasis. In these cases it is 
said to act almost like a specific. Piffard,* who has used it ex- 
tensively, recommends an infusion (V. tricolor, §j ; senna leaves, 
5ss ; boiling water, Oij), of which a tumblerful may be given 
twice a day for two or three days, after which the dose should 
be diminished. He finds it particularly serviceable in the 
second stage of eczema, with sero-purulent exudation and crust- 
ing. The fluid extract (Squibb's) may also be given ; in acute 
eczema, dose for a child, *KJ—v once or twice daily ; in chronic 
eczema, i^x-xv; for an adult the dose is f3ss-j. It should be 
taken in water, half an hour before meals. Sometimes it tem- 
porarily increases the severity of the eczema, and in these cases 
it should be discontinued for a day or two, or the dose may be 
lessened. 

* " Materia Med. and Therap. of the Skin," 1881, p. 115. 



CATHARTICS CASTOR OIL. 323 

CASSIA FISTULA. 

This is the fruit of Cassia Fistula or Purging Cassia {Nat. 
Ord. Leguminosae), a large tree of Egypt and the East Indies, 
now naturalized in the West Indies and South America. It 
consists of long, woody, dark-brown pods, about an inch in 
diameter and nearly two feet in length, which contain numerous 
seeds imbedded in a soft black pulp. The pulp is the part 
used, and has a faint nauseous odor and a sweet, rather pleasant, 
mucilaginous taste. It is, in small doses, a mild, agreeable laxa- 
tive, but its chief use is as an ingredient in the confection of senna. 
Dose, 3j to Sj. 

Oleum Oliv^e {Olive Oil). The well-known fixed oil ob- 
tained from the fruit of Olea europaea, or Olive Tree {Nat. Ord. 
Oleaceae), is nutritive, demulcent, emollient, and laxative. It is 
frequently prescribed as a constituent of laxative enemata. 

Oleum Amygdalae Expressum {Expressed Oil of Ahnond), a 
fixed oil expressed from the Sweet or Bitter Almond, is used 
for the same purposes as olive oil. 

OLEUM RICINI CASTOR OIL. 

Castor oil is the fixed oil obtained from the seed of Ricinus 
communis, or Palma Christi {Nat. Ord. Euphorbiaceae), a small 
perennial tree of India, now naturalized in many warm climates, 
and cultivated extensively in the United States. In India it 
attains a height of thirty or forty feet, but in this country it is 
an annual plant, about five or six feet in height, with round, 
thick-jointed, furrowed stems, of a purplish color above ; large 
peltato-palmate leaves, divided into seven or nine segments, on 
long round footstalks, and prickly, three-celled capsules, with 
a seed in each cell. The seeds are ovate, about the size of a 
small bean, and of a gray color, marbled with reddish-brown 
spots and stripes. They consist of a thin outer pellicle, an inner 
hard, blackish shell — both of which are inert — and a white 
oleaginous kernel, which contains the acrid principle. 

They possess considerable acridity, and in large quantities 
have produced death — the usual symptoms being vomiting and 
purging — and Taylor * records a case in which the eating of 

* Manual of Med. Jurisprudence, p. 224. 



324 MATERIA MEDICA ECCRITICS. 

twenty of the seeds killed a girl. Christison * states that the 
seeds will operate as a violent cathartic. Dr. Edson f has, how- 
ever, recently reported sixteen cases of non-fatal poisoning fol- 
lowing the ingestion of the bean, in none of which did catharsis 
occur. In each instance it was thought three or four were 
eaten. 

Castor oil is obtained by expression, by decoction, and by 
the agency of alcohol. The first method is the best, and is 
that which is pursued in this country, where large quantities 
are made, both for home consumption and exportation ; heat 
should not be employed in preparing it, as it renders it rancid. 
Thus procured, it is nearly colorless, or of a pale-yellow color, 
of a thick, viscid consistence, a faint, unpleasant odor, and a 
mild, nauseous taste, and becomes rancid and thick by exposure 
to the air. It is not soluble in water, but is extremely soluble 
in alcohol, readily so in ether, and forms soaps with alkalies. 
Its composition is not well understood ; its constituents would 
seem to be mainly ricinolein (a saponifiable oil resembling olein), 
ricinic acid, palmitin, and an acrid principle. A recent analysis 
of the stem, root and leaves by Beck J yielded volatile oil (non- 
saponifiable), wax, resin, alkalies, and an alkaloid termed ricinine 
(C^H^NttOs), identical with the alkaloid obtained by Tuson from 
the seed, and with the substance extracted by Wayne,§ from the 
leaves. The latter denies its claim to being called an alkaloid. 

Effects and Uses. — Castor oil is a mild and tolerably certain 
laxative, operating, when pure, in from four to six hours after 
its administration, without uneasiness in the bowels. It does 
not stimulate the liver nor increase the secretion of bile, but 
purges by a mild irritant action on the intestines (Rutherford ||). 
It is admirably adapted to all cases where a free evacuation of 
the bowels is desired, without abdominal irritation, as in dysen- 
tery, pregnancy, typhoid fever, etc., and is an excellent purga- 
tive for children. In dysentery or in diarrhoea due to the 
indigestion of unripe fruit, great benefit is often derived from 

* " A Treatise on Poisons," 4th ed., p. 590. 
f Brooklyn Med. Journ., Feb. 1888, p. 131. 

% Am. Journ. of Pharmacy, Feb., 1888, p. 93. "Analysis of Ricinus Com- 
munis." $ Ibid., 1874, p. 97. 
|| " Phys. Action of Drugs on Secretion of Bile." 1880. 



CATHARTICS — SULPHUR. 325 

an emulsion of oil with laudanum: 3^ Tincturae opii, f 5j ; 
Olei ricini, f ojss ; Pulveris acaciae, 5ij ; Sacchari albi, §ss ; 
Aquae cinnamomi, q. s. f§iij. M. et Sig. — Shake the bottle and 
take two teaspoonfuls every four hours. A similar prescription, 
modified according to age, will be found of service in the summer 
diarrhoeas of children. The leaves are said to possess galacta- 
gogne properties, and are applied to the breasts, in the form of 
decoction, to induce the secretion of milk. 

Administration. — For adults the dose is f oss-j ; for children, 
f 5i-f Sss. To cover its unpleasant flavor it is sometimes taken 
floating on spirit, coffee, mint-water, compound spirit of ether, 
etc., or made into an emulsion, or mixed with the froth of porter 
or a little oil of bitter almond. 

Flaxseed Oil and Melted Butter are laxative in the same 
doses as castor oil. 

SULPHUR. 

Sulphur exists in both kingdoms of nature. It is procured 
by the purification of native sulphur and by the decomposition 
of the native sulphides. The sulphur of commerce is generally 
obtained in the former way, chiefly from Sicily, and is termed 
crude sulphur. It comes also from Romagna, in Italy, and from 
California, and considerable deposits of sulphur have been found 
in the island of Saba, one of the Dutch West Indies, and in 
Japan. After importation it is purified by sublimation, and is 
known as sublimed sulphur — sulphur sublimatum. It is some- 
times sublimed in the form of an impalpable powder, when it is 
called the flowers of stdphur. Sometimes it is cast in wooden 
moulds, and forms the roll sulphur, or brimstone of commerce. 
Sublimed sulphur contains more or less sulphuric acid, and for 
medicinal use it is further purified by washing, when it consti- 
tutes the sulphur lotum or washed sulphur of the Pharmaco- 
poeia. As met with in the shops, it is a fine bright-yellow 
powder, with a feeble odor and taste, insoluble in water and in 
alcohol, but soluble in alkaline solutions, and the oils ; and when 
perfectly pure it is wholly volatilized by heat, and ought not to 
change the color of litmus-paper. 

Effects and Uses. — In small and repeated doses sulphur is a 
gentle stimulant to the skin and mucous membranes, and in 
larger doses it acts as a mild purgative, without exciting the pulse 



326 MATERIA MEDICA ECCRITICS. 

or occasioning griping. It is probably absorbed on being con- 
verted in the small intestine, by the alkali of the bile,, into a 
sulphide. After its continued use the intestinal gases give off 
sulphuretted hydrogen. 

It is employed in the cases to which laxatives are applicable, 
and also as an alterative diaphoretic in chronic cutaneous dis- 
eases, rheumatism and gout, and as an expectorant in pulmonary 
affections. It is considered a specially useful laxative in hemor- 
rhoids. To increase its cathartic effect it is often combined with 
cream of tartar or magnesia. Externally, it is a valuable remedy 
in various skin diseases, particularly scabies, in the strength of 
5j-iv to the oj of ointment. Before its application in scabies 
the patient should thoroughly wash the part with hot water and 
soft soap. 

Administration. — Dose, 5j-iij or iv, in syrup, treacle or milk. 
Externally, it is applied in the form of vapor bath or ointment. 
Ungnentum sulphuris consists of 30 parts of sulphur and 70 
parts of benzoinated lard rubbed together until thoroughly 
mixed. Unguentum sulphuris alkalinum {alkaline sulphur oint- 
ment) consists of sulphur, 20 parts, potassium carbonate, 10 
parts, water, 5 parts, and benzoinated lard, 65 parts, rubbed 
together until thoroughly mixed. 

Sulphur Pr^ecipitatum {Precipitated Sulphur, or Lac Sul- 
phuris) is prepared by boiling together sulphur, slaked lime and 
water and afterward precipitating the sulphur by hydrochloric 
acid. It is a finer and softer powder than sublimed sulphur, is 
of a paler yellow color, with a grayish tint, and is not often 
gritty between the teeth. When exposed to the air, however, 
it is liable to become contaminated with sulphuric acid, and, as 
found in commerce, it is often adulterated with calcium sulphate. 
Its effects, uses, and doses are the same as those of sublimed 
sulphur. 

Potassa Sulphurata {Sulphurated Potassd), or Liver of Sul- 
phur, is prepared by rubbing together one part of sublimed 
sulphur with two parts of potassium carbonate, afterward melt- 
ing the mixture, and pouring it when cold into a bottle. Its 
composition is variable and uncertain, but it should contain 
about 50 per cent, of potassium sulphide. When freshly and 
carefully prepared it is of a liver color, has an acrid, alkaline, 



SALINE CATHARTICS. 327 

disagreeable taste, and forms an orange-yellow solution wfth 
water. This preparation and the other sulphides probably act 
like sulphur. They are, perhaps, in part decomposed by the 
acids of the stomach, but any liberated sulphur must be again 
combined with the alkali of the bile. 

Taken in large quantities sulphurated potassa is a corrosive 
poison, capable of producing fatal gastro-enteric inflammation. 
Three cases of poisoning are reported from it by Orfila,* in one 
of which 5iij proved fatal. 

The sulphides are considered to be expectorant, diaphoretic j 
and alterative. They have been especially recommended in 
the scrofulous abscesses of children — the calcium sulphide being 
preferred. Dose, for an adult, gr. ij-x, several times a day. 
They are used externally in scaly skin diseases in the form of 
ointment (5ss to oj of lard) and of baths. 



SALINE CATHARTICS. 

Before considering in detail the precise action on the alimentary 
tract of the saline cathartics, a brief argument will be offered 
relating to the opinions and work of the investigators who have 
experimented physiologically with these substances. There has 
been much controversy between numerous experimenters as to 
their exact method of action upon the intestinal canal, the ques- 
tion being this: Do they effect catharsis by inciting peristalsis; 
or is it due to increased discharge of fluids? Considerable prac- 
tical evidence has been brought forward by Thiry and Radziejew- 
sky to prove that cathartic drugs, especially the drastics, operate 
by arousing peristalsis, but their work, though apparently accurate, 
lacks the confirmation of observers whose results cannot be im- 
pugned, and, moreover, the latter have much clinical evidence to 
substantiate their side of the question. Among those who have 
devoted largely of time and labor in the laboratory to the elucida- 
tion of the action of the salines are Lauder Brunton,f Anstie,J 

* " Toxicologic Generate," Vol. I, p. 177. 

f Practitioner, Vol. xn, pp. 342 and 403. " On the Action of Purgative Medi- 
cines." 

% Med. Times and Gazette, Vol. I, pp. 326 and 487. " Report on the Action of 
Podophyllin." 



328 MATERIA MEDICA — ECCRITICS. 

Moreau,* Matthew Hay f and Vulpian.J The work of Hay, with 
whom we agree, is most elaborate, being- a model of research. 
Concisely stated, all of these observers are unanimously of the 
opinion that catharsis is induced chiefly by augmented intestinal 
secretion, and they offer many incontrovertible facts to substan- 
tiate their opinions. We quote some of Hay's conclusions : — 

" A saline purgative always excites more or less secretion 
from the alimentary canal, depending on the amount of the salt 
and the strength of its solution, and varying with the nature of 
the salt. The excito-secretory action of the salt is probably due 
to the bitterness as well as to the irritant and specific properties 
of the salt, and not to osmosis. The low diffusibility of the salt 
impedes the absorption of the secreted fluid. Purgation will not 
ensue if water be withheld from the diet for one or two days 
previous to the administration of the salt in a concentrated form. 
Cczteris paribus, the weaker, or, in other words, the more volu- 
minous the solution of the salt administered is, the more quickly 
is the maximum within the canal reached ; and accordingly 
purgation follows with greater rapidity. 

" The salt excites an active secretion in the intestines, and 
probably for the most part in the small intestine, all portions of 
this viscus being capable of yielding the secretion in almost 
equal quantities. The bile and pancreatic juice participate but 
very little in the secretion. The salt does not purge when 
injected into the blood, and excites no intestinal secretion. Nor 
does it purge when injected subcutaneously, unless in virtue of 
its causing local irritation of the abdominal subcutaneous tissue, 
which acts reflexly on the intestines, dilating their blood vessels, 
and perhaps stimulating their muscular movements. The sul- 
phate of soda exhibits no poisonous action when injected into 
the circulation. The sulphate of magnesia is, on the other hand, 
powerfully toxic when so injected, paralyzing first the respiration 
and afterward the heart. Both salts, when administered in the 
usual manner, produce a gradual but well-marked increase in the 

* Arch. Gen. de Med., XVI, 6ieme ser., p. 234. " L'action du sulphate de magnesie 
sur l'intestin." 

\Journ. of Anat. and Phys.,Yo\. xvi, pp. 343, 391 ; Vol. XVII, pp. 62, 223, 465. 
"The Action of Saline Cathartics." 

t Gazelle Medicate de Paris, 1873, p. 300. 



CATHARTICS HEAVY MAGNESIA. 329 

tension of the pulse. The blood recoups itself in a short time by 
absorbing from the tissues a nearly equal quantity of their fluids. 
The salt after some time causes diuresis. The amount of the 
normal constituents of the urine is not affected by the salt. The 
salt has no specific action in lowering the internal temperature 
of the body." 

Lauder Brunton (loc. cit) differs from Hay's (loc. cit) conclu- 
sions in that he found that purgatives reduced the arterial 
pressure, as shown by the sphygmograph. 

Clinically, the results of these observers are supported by the 
fact that watery stools are characteristic of the exhibition of the 
salines in sufficient doses. 

MAGNESIA MAGNESIA. 

MAGNESIA PONDEROSA HEAVY MAGNESIA. 

Magnesia (MgO), sometimes called calcined magnesia, from the 
mode in which it is prepared, is procured by exposing mag- 
nesium carbonate to a red heat, till the carbonic acid is wholly 
expelled. It is a light, fine, white, colorless, odorless powder, of 
a feeble, earthy taste, very slightly soluble in water, and more 
soluble in cold than in hot water. Heavy magnesia is a white, 
fine, dense powder, chemically identical with magnesia and 
differing with it only in the degree of aggregation of their mole- 
cules. Heriry's Magnesia, a patent English medicine, has the 
advantage over the ordinary magnesia of greater density and 
softness, and more ready miscibility with water, and corresponds 
to the officinal magnesia ponderosa. Magnesia prepared by 
Husband, and Ellis, of Philadelphia, is very similar in properties 
to Henry's. 

Effects and Uses. — Magnesia is antacid and laxative. A good 
deal of its cathartic effect is the result of its combination with 
the free acids of the stomach and intestines, in which soluble 
magnesian salts are formed. When taken in large quantities, 
and for too long a period, it sometimes accumulates in the 
bowels ; and hence it is best to increase its solubility by giving 
it with lemonade. It is an excellent laxative where much acidity 
exists in the stomach, and is particularly useful in mfantile cases. 
As an antacid it is employed in heartburn, sick headache and 



330 MATERIA MEDICA ECCRITICS. 

nephritic complaints. Dose, as a laxative, 5j ; as an antacid, gr. 
xx, in water or milk. Of Henry's, half the quantity. 

MAGNESII CARBONAS — MAGNESIUM CARBONATE. 

Magnesium carbonate, sometimes called magnesia alba, is pre- 
pared by decomposing magnesium sulphate with an alkaline car- 
bonate. As found in the shops it is a combination of magnesium 
carbonate and magnesium hydrate (4MgCo 3 ,Mg2HO,5H 2 0). It 
occurs in the form of light, white, cubical cakes or powder ; is 
inodorous, almost insipid, and nearly insoluble in water, but 
soluble in carbonic acid water. 

Its effects and uses are nearly the same as those of calcined 
magnesia; but from its effervescence with the acids of the 
stomach, it is apt to create flatulence, though sometimes, on 
this account, more acceptable to delicate stomachs. Dose, as a 
laxative, 5j-ij ; as an antacid, gr. x. 

MAGNESII SULPHAS MAGNESIUM SULPHATE. 

This salt (MgS0 4 .7H 2 0), commonly called Epsom Salt, from 
its having been first procured from the Epsom mineral water in 
England, occurs in native crystals, and is a constituent of sea- 
water and many saline springs. It is obtained in England from 
dolomite, or magnesian limestone ; and also from bittern, or the 
residual liquor of sea-water, from which common salt has been 
separated. In this country it is extensively manufactured at 
Baltimore and Philadelphia, by the action of sulphuric acid on 
magnesite, the silicious magnesium hydrate. It is usually met 
with in small acicular crystals, which are colorless, transparent 
and odorless, but have an extremely bitter taste. They effloresce 
on exposure to the air, are very soluble in water, and insoluble 
in alcohol. 

Effects and Uses. — Epsom salt is a mild, safe, refrigerant pur- 
gative, which, from its cheapness, is by far the most commonly 
employed of all cathartics. It produces free, watery purgation, 
with very little irritation of the intestines, stimulating the intes- 
tinal glands, but not affecting the liver. 

Matthew Hay* has called attention to the efficacy of concen- 

* Lancet, April, 1883, p. 678. 



CATHARTICS SOLUTION OF MAGNESIUM CITRATE. 33 I 

trated saline cathartics for the removal of dropsical effusions. He 
states that they concentrate the blood, increase the proportion 
of red globules, and produce watery stools. He used of Epsom 
salt 0% to water fSj. Osier* reports favorable results with 
Hay's method in diminishing pleuritic effusions. He employed 
5iv-vj to water fSj. The stomach should be empty at the time 
of administration and the patient should not drink for some 
time afterward. In the treatment of lead-colic and the cachexia 
resulting from chronic lead-poisoning, this salt, combined with 
diluted sulphuric acid, is of the greatest service. It is also used 
in combination with opium in acute dysentery, but is inferior 
to Rochelle salts in the treatment of this complaint. It is some- 
times combined with senna, sometimes with bitter infusions, and 
is most agreeably administered in solution in carbonic acid 
water. Dose, §ss-j. 

LIQUOR MAGNESII CITRATIS SOLUTION OF MAGNESIUM CITRATE. 

Under this name magnesium citrate is employed in solution, 
with slight excess of acid, and in the effervescing state. It is 
prepared according to the following formula : citric acid gr. 400 
are dissolved in water gr. 2000, and in this solution magnesium 
carbonate gr. 200 are stirred until dissolved ; this solution is 
filtered into a strong twelve-ounce bottle, containing syrup of 
citric acid gr. 1200; to this is added water previously boiled and 
filtered enough to nearly fill the bottle ; potassium bicarbonate 
gr. xxx are then dropped in and the bottle is immediately closed 
with a cork, and secured with twine ; the mixture must be occa- 
sionally shaken to insure the solution of the bicarbonate. The 
effervescing solution has a pleasant acid taste, without anything 
disagreeable. It is a very grateful cathartic, and is much em- 
ployed as a substitute for Epsom salt, but is more apt to produce 
slight griping. Dose, from a half to a whole bottle. 

Magnesii Citras GRANULATUs(6Vtf;«//<2^/ Magnesium Citrate) 
is a white, coarsely-granular salt, deliquescent on exposure to 
air, odorless, having a mildly acidulous, refreshing taste, and an 
acid reaction. Soluble with copious effervescence in two parts of 
water ; almost insoluble in alcohol. It should be kept in closely- 

* The Med. News, Dec, 1886, p. 645. 



332 MATERIA MEDICA ECCRITICS. 

stoppered bottles. Its effects are similar to those of the solution, 
and it is used for the same purpose. It has the advantage of 
portability. Dose, 5j-iv dissolved in water and taken while 
effervescing. 

SODII SULPHAS SODIUM SULPHATE. 

Sodium sulphate, commonly called Glauber's Salt (Na 2 S0 4 . 
ioH 2 0), is a constituent of many mineral springs, and is prepared 
in various chemical processes. It occurs as a residuum in the 
manufacture of hydrochloric acid, made by adding sulphuric 
acid to sodium chloride, and it is obtained from sea-water in the 
winter season. It is found in colorless, six-sided, very efflores- 
cent crystals, which are inodorous, but have a cooling, saline, 
very bitter taste. It is soluble in water — more readily in hot 
than in cold water — and is insoluble in alcohol. 

Its effects and uses are very similar to those of Epsom salt, but 
it is more bitter and nauseous, and is now little used. It is a 
mild hepatic stimulant, according to the experiments of Ruther- 
ford on dogs. The effects of the sodium salts have already been 
considered (vide page 246). It has an antiplastic action on the 
blood, due to the sodium which it contains. Dose, oj ; in an 
effloresced state, 5ss. 

MANGANI SULPHAS MANGANESE SULPHATE. 

This salt (MnS0 4 4H 2 0) is made by heating the native black 
oxide with concentrated sulphuric acid. It occurs in rhombic, 
prismatic crystals, of a pale-rose or pink color, transparent, and 
of an astringent, bitterish taste. It is very soluble in water, in- 
soluble in alcohol. 

In its effects it is said to resemble Glauber's Salt, acting also as 
a cholagogue. Dose, as a purgative, 3j-ij. As a tonic (vide p. 
168) it has been given in doses of gr. v-xx. 

SODII PHOSPHAS SODIUM PHOSPHATE. 

This salt is prepared by digesting powdered burnt bone with 
diluted sulphuric acid, and decomposing the resulting monocalcic 
phosphate with sodium carbonate. It is disodic phosphate, and 
occurs in large rhombic, colorless, transparent, very efflorescent 
crystals (Na 2 HP0 4 .i2H 2 0), which are wholly soluble in water 



CATHARTICS POTASSIUM SULPHATE. 333 

and insoluble in alcohol, and have a pleasant saline taste, resem- 
bling that of common salt. 

Effects and Uses. — Sodium phosphate is a mild saline cathartic, 
well adapted, from its agreeable taste, to the cases of children and 
delicate persons. It is a hepatic stimulant, increasing the amount 
of bile secreted, although making it more watery, and having a 
very slight irritant action on the intestinal mucous membrane 
(Rutherford). It increases the alkalinity of the blood and dimin- 
ishes the amount of urea excreted. It is a constituent of the blood 
in health, and has been recommended in cholera as a restorative 
of deficient saline matters, to repair the drain on the system 
caused by chronic suppurations, and also in diseases where there 
is a deficiency of phosphatic matter in the bones. In all catarrhal 
conditions of the gastro-intestinal mucous membrane, notably in 
catarrhal jaundice, sodium phosphate is of the greatest utility. It 
is highly recommended also in chronic infantile diarrhoea with 
pasty stools (Routh). Dose, as a cathartic, 5yj-xij, in broth or 
soup. As an alterative, gr. xx— 5j, three or four times a day. 

Sodii Pyrophosphas {Sodium Pyrophosphate) (Na 4 P 2 7 .ioH 2 0) 
occurs in colorless, translucent prisms, odorless, but having a 
cooling, saline taste, and a slightly alkaline reaction. The effects 
and uses are said to resemble those of sodium phosphate. Dose, 
5ss-iv. 

POTASSII SULPHAS POTASSIUM SULPHATE. 

This salt exists in both kingdoms of nature, and is obtained 
artificially from the residuum of the distillation of nitric acid from 
potassium nitrate and sulphuric acid. It occurs in small, hard, 
colorless, inodorous crystals (K 2 S0 4 ), of a saline, bitter taste, which 
have no water of crystallization, and are unalterable in the air. 
They are moderately soluble in water, and are insoluble in alcohol. 

Effects and Uses. — The physiological effects of the potassium 
salts have already been fully considered {vide p. 244). In small 
doses it is considered a mild and safe cathartic ; but in large doses 
it has proved a violent and even fatal poison, producing symptoms 
of cholera. It is thought to act as a lactifiige, and is adminis- 
tered with this view in France. Dose, as a cathartic, gr. xv— 5j- ij ; 
but it is little employed in this country. From its hardness and 
dryness it is useful to promote the trituration and division of 
powders. 



334 MATERIA MEDICA ECCRITICS. 

POTASSII BITARTRAS POTASSIUM BITARTRATE. 

This salt, well known as Cream of Tartar, and termed also acid 
potassium tartrate, is the monopotassic tartrate (KHC 4 H 4 6 ). It 
exists in many vegetable juices, particularly the juice of grapes, 
from which it is obtained. It is deposited in an impure form, 
during fermentation, on the sides of wine-casks, and in this state 
occurs in crystalline cakes, of a reddish color, known as argol or 
crude tartar. This is purified by solution and crystallization, and 
forms a white crystalline mass or powder, termed cream of tartar. 
It is without smell, has an acidulous and gritty taste, is very 
slightly soluble in water, and insoluble in alcohol ; when heated 
in a close vessel, it is converted into black flux, a compound of 
charcoal and potassium carbonate. 

Effects and Uses. In small doses it is diuretic and refrigerant ; 
in larger doses, cathartic ; and in excessive doses it will produce 
gastro-intestinal inflammation. It is employed to form a refrig- 
erant drink, and as a gentle aperient in fevers ; as a diuretic and 
hydragogue cathartic in general dropsy depending on valvular 
disease of the heart, and in desquamative nephritis. Dose, as an 
aperient, 5ss-j ; as a cathartic \ oss-j ; as a diuretic, gr. x-5j, in 
repeated doses. It enters into the compound powder of jalap. 

POTASSII TARTRAS POTASSIUM TARTRATE. 

This salt, formerly called Soluble Tartar, is obtained by satu- 
rating the excess of acid in cream of tartar with potassium 
carbonate, and is dipotassic tartrate (2K 2 C 4 H 4 6 .H 2 0). It occurs 
in white deliquescent crystals or grains, of a saline, somewhat 
bitter taste, and is very soluble in water. It is a gentle cathartic 
and diuretic, at present not much used. Dose, §ss to j. 

POTASSII ET SODII TARTRAS POTASSIUM AND SODIUM TARTRATE. 

This salt (KNaC 4 H 4 6 4H 2 0), commonly called Rochelle Salt, 
is made by saturating the' excess of acid in cream of tartar with 
sodium carbonate. It occurs in large, transparent, colorless, 
prismatic, slightly efflorescent crystals, of a mildly saline and 
bitter taste, readily soluble in cold water, and still more so in 
hot water. It is the best saline for use in the treatment of acute 
dysentery, combined with opium and given in small doses fre- 
quently repeated until 5J has been taken in the first 24 hours, 



CATHARTICS RHUBARB. 335 

after which the dose is decreased. 1^ Potassii et sodii tartra^ 
tis, 5j ; tincturae opii, *% x ; aquae, fgss. M. S. — Every two hours. 
It is a mild and pleasant aperient, well adapted to gouty cases 
and cases of uric acid lithiasis, but it renders the urine alkaline, 
and should not therefore be given to persons suffering with 
phosphatic deposits in the urine. Dose, Sss-j. It is usually 
exhibited in the form of pulvis effervescens compositus {compound 
effervescing pozuder), or Seidlitz powder, which consists of Rochelle 
salt (3ij) and sodium bicarbonate (gr. xl) in a blue paper, and 
tartaric acid (gr. xxxv) in a white paper. They are taken, dis- 
solved in half a pint of water, while the liquid is in a state of 
effervescence, and form a very agreeable mild aperient, and are 
very acceptable to the stomach. They should not be kept in a 
damp place. 

MILD ACRID CATHARTICS. 
RHEUM RHUBARB. 

Rhubarb is the root of Rheum officinale, and of other species 
of Rheum (Nat. Ord. Polygonaceae). Several varieties of rheum 
are cultivated in Europe and this country, the leaf-stalks of which 
make excellent tarts. Rhubarb is prepared for the market by 
being cleansed, deprived of its cortical portion, cut into pieces, 
pierced through the centre, strung upon a cord, and dried in the 
sun. Three principal sorts were long known : Chinese, Russian 
or Turkey, and European. The first two were obtained, by dif- 
ferent routes, from central Asia. I. Chinese rhubarb is the com- 
mon variety, and is imported principally from Canton. It occurs 
in roundish pieces, sometimes flattened, of a dirty brownish- 
yellow color externally (the cortical portion apparently scraped 
off), having a ragged fracture (which presents red, yellowish and 
white veins), and is often perforated with holes, with portions of 
the cord on which it was dried occasionally remaining. It has 
a peculiar odor, an astringent, somewhat bitter taste, is gritty 
when chewed, and tinges the saliva of a yellow color ; its powder 
is yellowish, with a reddish-brown tinge. 2. Russian rhubarb has 
within a few years past disappeared as an article of commerce, 
and will not therefore be described. 3. European rhubarb is of 
uncertain quality, and is seldom found in the shops. The kind 
most frequently met with is English rhubarb, which is thought 



336 MATERIA MEDICA ECCRITICS. 

to be derived from R. rhaponticum, and generally comes in 
pieces five or six inches long and about an inch thick, and is 
called stick-rlmbarb. It is lighter, more spongy and redder than 
the Asiatic varieties, with a feebler odor and less bitter taste, and 
when broken exhibits a more compact and regular marbling. 
Lately the production of English rhubarb has much increased, 
and its quality has improved. 

Rhubarb imparts its virtues to both water and alcohol, but they 
are impaired by long boiling. Its most important chemical con- 
stituents seem to be chrysophan, chrysophanic acid (C 15 H 10 O 4 ) (an 
orange-yellow crystalline substance, which is probably the active 
ingredient of goa powder, and will be considered in the article 
chrysarobin — vide Rubefacients), four resins, erythroretin, emodin, 
ph&oretin, aporetin, and two acids, rheotannic (C^H^O^ and 
rheumic (C^H^Og), but the precise chemical constituents of rhu- 
barb are still uncertain, though they have been subjected to 
numerous analyses. It is supposed the therapeutical properties 
of the drug depend chiefly on the conjoint operation of these 
principles. 

Effects and Uses. — In small doses, rhubarb is an astringent tonic. 
In larger doses, it is a slow and mild cathartic, occasionally causing 
griping and accelerating the pulse, but never inflaming the mu- 
cous membrane of the alimentary canal like the drastics. It tinges 
the milk and urine yellow. It increases the secretion of bile, 
which, however, is unaltered in composition (Rutherford). 

It is much employed as a purgative in diarrhoea, in which it 
is particularly useful from its secondary astringent effects, and in 
dyspepsia attended with costiveness, where it acts both as a 
stomachic and laxative. It is not adapted to febrile or inflam- 
matory cases. In the bowel complaints of children, rhubarb 
deservedly enjoys great popularity. Made into a cataplasm and 
applied to the abdomen, it acts as a purgative on children. 

Administration. — Dose, as a stomachic laxative, gr. v-x ; as a 
purgative, gr. xx-5j. The following are the officinal preparations : 
Extract (alcoholic), dose, gr. x-xxx ; fluid extract, dose, f5ss ; 
mixture of rhubarb and soda contains sodium bicarbonate, fluid 
extract of rhubarb and spirit of peppermint, each 30 parts, water 
enough to make 1 000 parts — an excellent preparation where 
rhubarb is indicated, combined with an antacid, especially adapted 



CATHARTICS ALOES. 337 

to children — dose, for a child, foss-j, for an adult, foj-iv, or more ; 
tincture (ioo parts contain 12 parts of rhubarb and 2 parts of 
cardamom, in diluted alcohol) ; aromatic tincture of rhubarb con- 
tains also cinnamon, cloves, and nutmeg, and is used in making 
the aromatic syrup ; sweet tincture of rhubarb contains also gly- 
cyrrhiza, anise, and cardamom ; tincture of rhubarb and senna 
(Warner's gout cordial), tincture of rhubarb and aloes and tincture 
of rhubarb and gentian are no longer officinal : the dose of all the 
tinctures is f§ss— j, and they are chiefly adapted to low forms of 
disease and persons accustomed to the use of stimulants ; pills of 
rhubarb, each pill contains rhubarb gr. iij, and soap gr. j ; com- 
pound pills of 'rhubarb >, each pill contains rhubarb gr. ij, aloes gr. 
iss, myrrh gr. j, oil of peppermint gr. -^; compound powder of 
rhubarb (containing 25 parts of rhubarb, 65 parts of magnesia, 
and 10 parts of ginger); syrup contains also cinnamon, potassium 
carbonate, sugar, and water; aromatic syrup (contains aromatic 
tincture, 10 parts, syrup, 90 parts — much used in infantile cases 
under the name of spiced syrup of rhubarb) — dose, for an infant, 
f.3j ; and wine contains rhubarb, 10 per cent., and calamus, 1 per 
cent, in stronger white wine — dose, f5j— f Sss. Roasting impairs 
the cathartic power of rhubarb, and is said to increase its 
astringency. 

Juglans. The inner bark of the root of Juglans cinerea, 
or Butternut (Nat. Ord. Juglandaceae), an indigenous forest tree, 
found throughout New England, the middle and western States 
and Canada, possesses cathartic properties resembling those of 
rhubarb. It is of a fibrous texture, a white color, gradually 
changing to a dark-brown, a feeble odor, and a bitter, somewhat 
acrid, taste. It contains nucin, C 36 H 12 O 10 (composed of juglandic 
acid and juglone), some tannic acid, fixed and volatile oils, resin, 
etc. It is not given in substance ; the extract is officinal, of which 
the dose is gr. v-x as a laxative, and gr. x-xxx as a decided 
cathartic. 

aloe — aloes. 

Aloes is the inspissated juice of the leaves of Aloe soco- 
trina {Nat. Ord. Liliaceae), a succulent herbaceous plant grow- 
ing in warm countries. Aloes obtained from other varieties of 
aloe is used, but the Pharmacopoeia only recognizes Aloe soco- 



338 MATERIA MEDICA ECCRITICS. 

trina as the source of officinal aloes. The finest kinds are 
obtained by exudation ; those prepared by expression and by 
boiling are inferior. Three principal varieties are known in 
commerce : Cape, Socotrine, and Barbadoes aloes, the first two 
of which are the most used in the United States. 1. Cape aloes 
(Aloe capensis), which is much the most common, is obtained 
from the Cape of Good Hope, where it is collected indiscrimi- 
nately from A. spicata and other species. Its powder is green- 
ish-yellow; its odor is strong and disagreeable, but not nau- 
seous. 2. Socotrine aloes (Aloe socotrind), when genuine, is the 
choicest variety. It is produced in the island of Socotra, on the 
eastern coast of Africa, from A. socotrina, and occurs in pieces of 
a yellowish or reddish-brown color., becoming darker on expo- 
sure to the air, with a smooth and conchoidal fracture, the 
interior being lighter-colored than the exterior. Its powder is 
golden-yellow ; its odor peculiar, but not unpleasant, and its 
taste bitter and disagreeable, but aromatic. Hepatic aloes is 
probably an inferior variety of Socotrine, and is seldom met 
with in our shops. 3. Barbadoes aloes (Aloe barbadensis) comes 
from the West Indies, the product chiefly of A. vulgaris ; it is 
imported in gourds. The taste of all the varieties of aloes is 
intensely bitter and very tenacious ; their odor, disagreeable. 

Aloes yields its virtues to water and alcohol. A neutral crys- 
talline principle, termed aloin, has been extracted from it, which 
is supposed to be the cathartic principle, and which has been 
used as a purgative in doses of gr. y 1 — ij ; that from Socotrine 
aloes is termed socalotn (C 15 H 16 7 ), of Barbadoes, barbalo'in 
(C 17 H 20 O 7 ), and of Natal, nataloin (C 16 H 18 7 ). The resin of aloes, 
when exhausted of aloin, possesses no purgative properties. 

Effects and Uses. — Aloes, in small doses, is tonic, and in large 
doses, purgative. As a cathartic, it is remarkable for the slow- 
ness of its operation and its special action on the large intestine 
and the pelvic viscera generally. Hence it is objectionable in 
cases of disease of the genito-urinary apparatus, pregnancy, etc.; 
and, on the other hand, is useful in amenorrhcea. It also stimu- 
lates the hepatic secretion. 

It is principally employed in cases of dyspepsia accompanied by 
costiveness, dependent on a torpid condition of the large intestine 
or liver. In chronic constipation, combined with belladonna and 



CATHARTICS SENNA. 339 

nux vomica and continued for some time in small doses, it often 
proves advantageous. 3^ Alo'in, gr. -^ ; extracti nucis vomicae, 
gr. J- ; extracti belladonnas, gr. -j^. M. ft. pill. Sig. — One pill 
t. d. after meals, to be reduced to two per diem if it cause more 
than one daily evacuation. Active exercise, massage and regular 
habits add greatly to the efficiency of this treatment. It is also 
useful as a mild revulsive in cerebral affections, and has proved 
efficacious as an anthelmintic. It was once thought that it was 
objectionable in hemorrhoids, but this affection being now con- 
sidered to depend upon relaxation of the veins of the rectum, 
aloes has been administered in it upon theoretical views, and with 
very good results. As a purgative it holds an intermediate rank 
between rhubarb and senna. 

Administration. — Dose, gr. v or x-xx, in pill ; it is usually 
given in combination with other cathartics. Aloes is so often 
mixed with impurities that, for medicinal use, it is best employed 
under the form of aloe purijicata {purified aloes), which is pre- 
pared by straining and evaporating an alcoholic solution of Soco- 
trine aloes. The officinal preparations are : Pills of aloes, con- 
sisting of equal parts of aloes and soap, one pill containing aloes 
gr. ij ; pills of aloes and mastic, 4 parts of aloes to 1 part of 
mastic and red rose, each (the Lady Webster pill, each containing 
aloes gr. ij); pills of aloes and asafoetida (one pill contains of 
aloes, asafoetida, and soap, ]\ gr. each), useful in flatulent consti- 
pation ; pills of aloes and myrrh, or Rufus's pills, aloes 4 parts, 
myrrh 2 parts, and aromatic powder I part, made into pills with 
syrup ; employed in amenorrhcea, each pill containing aloes gr. ij - 
pills of aloes and iron, equal parts of aloes, dried iron sulphate 
and aromatic powder, made into pills with confection of rose ; 
each pill contains aloes gr. j ; very useful in amenorrhcea ; aqueous 
extract of aloes (extractum aloes aquosum), dose, gr. j-v ; tincture 
(aloes and extract of glycyrrhiza, of each 10 per cent., in diluted 
alcohol), dose, foj to fSss ; tincture of aloes and myrrJi{z\oz$ and 
myrrh, each 10 per cent., in alcohol) ; wine of aloes (aloes 6 
per cent., cardamom and ginger each 1 per cent, in stronger 
white wine). 

SENNA. 

Senna consists of the leaflets of several species of Cassia 
{Nat. Ord. Leguminosae), small shrubs which grow in the trop- 



34-0 MATERIA MEDICA ECCRITICS. 

ical regions of Asia and Africa. The species recognized as 
officinal are C. acutifolia and C. elongata ; and besides these, C. 
obovata, C. lanceolata, and C. aethiopica are also generally 
received as sources of the drug. The commercial varieties of 
senna which are found in the United States are the Alexandria, 
the Tripoli, the India and the Mecca senna. I. Alexandria semia, 
which comes from the port of this name in Egypt, is made up 
chiefly of the leaflets of C. acutifolia (which are yellowish-green, 
acute in shape, and less than an inch in length), intermingled 
with the pods, leafstalks, flowers, etc., of this plant. 2. Tripoli 
senna consists of the leaflets of C. sethiopica, which are shorter, 
less acute, thinner and more fragile than those of C. acutifolia, 
and are generally much broken up. 3, India senna is produced 
in Arabia and consists of the leaflets, intermixed with the leaf- 
stalks and pods, of C. elongata, and is readily recognized by the 
long, narrow, pike-like shape and dark hue of the leaflets. A 

Fig. 28. Fig. 29. 





ALEXANDRIAN SENNA. INDIAN SENNA. 

finer variety of India senna, cultivated at Tinnevelly ', in Hindostan, 
has been known for some years past, which is distinguishable 
from the common sort of India senna by the bright-green color 
of the leaflets. 4. Mecca senna consists of leaflets, intermediate 
in length between those of C. acutifolia and C. elongata, and has 
in mass a yellowish, tawny hue. It is probably the product of 
C. lanceolata. Cassia obovata has been lately found growing 
wild in abundance in Jamaica. 

Commercial senna is prepared for use by separating the leaflets 
from the stalks, adulterations, etc. ; the pods possess cathartic 
properties, but are less active than the leaves. The odor of senna 
is faint and sickly ; its taste bitter, sweetish and nauseous. It 
imparts its virtues to water and alcohol, its infusion being of a 
reddish-brown color. The chemical composition of senna has long 
been an unsettled point. By the latest analysis it has been found 
to contain a glucoside, cathartic acid, which is insoluble in water, 
stronger alcohol and ether, but which enters readily into watery 



CATHARTICS LEPTANDRA. 34 1 

solution with alkaline and earthy bases, in which state it exists 
in senna ; this is actively cathartic. Catharto-mannit {sennit), 
sennacrol and chrysophan have been also obtained ; and there is 
probably another purgative principle which has not been isolated. 

Effects and Uses. — Senna is a prompt, efficient and safe catliar- 
tic, well adapted to febrile and inflammatory cases ; it operates 
on the entire tract of the intestinal ca?tal, and produces watery, 
feculent discharges. Prof. Rutherford found that senna was a 
mild hepatic stimulant, and rendered the bile more watery. Its 
tendency to gripe may in a great measure be counteracted by 
combining aromatics or neutral salts with it ; the addition of bitters 
promotes its cathartic activity. 

Administration. — The dose in powder is 5ss-ij ; Confectio senna 
(made with senna, coriander, sugar, figs and pulp of prunes, tama- 
rinds and purging cassia) is an excellent mild cathartic, much 
used for pregnant women ; dose, 5ij. Of the fluid extract the 
dose is f 5j-iv ; the compound infusion (black draught) contains 
senna, manna, magnesium sulphate and fennel ; dose, f§ss— j or 
more. Syrup of senna contains senna, sugar, alcohol and oil of 
coriander; dose, f5j. Pulvis glycyrrhizcz compositus {compound 
powder of glycyrrhizd) consists of senna, glycyrrhiza, fennel, 
washed sulphur and sugar. It is an excellent purgative ; dose, 
a teaspoonful of the powder in half a glass of water at bedtime. 

LEPTANDRA. 

The rhizome and rootlets of Leptandra virginica, Culver's 
Root, or Culver's Physic {Nat. Ord. Scrophulariaceae), an herb- 
aceous perennial plant, three or four feet high, with leaves in 
whorls, and a long spike of white flowers, are ranked as a chola- 
gogue cathartic. It consists of a dark-brown rhizome, from two 
to four lines in thickness, several inches in length, with numer- 
ous long, slender radicals. The odor is feeble and disagreeable, 
the taste bitterish and somewhat nauseous and acrid. Water 
and alcohol extract its virtues, which depend on leptandrin. It 
also contains resin, saponin, tannin, mannit, etc. It is only a 
feeble stimulant to the liver and intestinal glands, according to 
the investigations of Rutherford. Adolphus * states that it acts 
on the small intestines, pancreas, and liver, while Dutcherf 

* Boston Med. and Surg. Reporter, 1868, p. 23. \ Ibid., 1868, p. 275. 



342 MATERIA MEDICA ECCRITICS. 

thinks it stimulates the intestinal glands only, but they offer no 
evidence to prove their statements. Dose of the powdered root, 
gr. xx to 5j ; of an impure resin misnamed leptandrin (made by 
precipitating a tincture of the root with water), gr. ij-iv ; an 
extract (dose, gr. ij— iv) and fluid extract (dose, f 5ss-j) also have 
been used. 

FRANGULA. 

The bark of Rhamnus Frangula,* or Alder Buckthorn {Nat. 
Ord. Rhamnaceas) is a mild purgative of some value. Fran- 
gula is a shrub growing to the height of ten feet or more, found 
in wet places along the northern coast of Africa, throughout 
Europe, and in Siberia. It has alternate oval leaves, slightly 
pointed at the apex, greenish flowers in axillary clusters and 
small red berries, which finally become black and contain two or 
three roundish-angular seeds. The bark comes in small quills, 
grayish or blackish-brown externally, and marked with numer- 
ous small, whitish, transversely elongated warts ; the inner sur- 
face is smooth, pale, brownish-yellow. It has no smell and a sweet 
and bitterish taste. 

It contains frangulin (C 2 oH2o0 10 ), einodin, resin, tannin, etc. 
When fresh the bark is an active emetic and hydragogue cathar- 
tic, possessing irritant qualities, but it loses much of its acridity 
in drying, and it is therefore recommended by the Pharmaco- 
poeia to be collected at least a year before it is used. When 
dried it is a mild acrid cathartic, proving also somewhat diuretic. 
It is also an anthelmintic of considerable value. The fluid extract 
may be given in doses of f 5ss— j. 

CASCARA SAGRADA. 

Cascara sagrada * or Chittem bark (unofBcinal) is the bark of 
Rhamnus purshiana {Nat. Ord. Rhamnaceae), a small tree found 
on the Pacific slope, growing to the height of ten to twenty feet, 
with elliptic denticulate leaves, rather large white flowers in 
umbellate clusters, and three-lobed, three-seeded black drupes. 
The bark comes in thin quills, with a grayish periderm, under- 
neath which it is of a reddish-brown color ; the inner surface is 
smooth and yellowish. It is without smell, but has a bitter taste. 

* Med. Times, Dec. 5th, 1887, on " R. Frangula and Purshiana," Rusby. 



CATHARTICS JALAP. 343 

It contains three resins, viz., a brown, red, and yellow, which are 
probably the purgative principles, and recently a ferment, glucose, 
and traces of ammonia have been isdlated.* 

Effects and Uses. — From experiments on dogs in the labora- 
tory of Prof. S. P. Botkin, Dr. M. M. Tcheltzoff deduces the 
following resultsf : — 

Administered internally the fluid extract (4-10 c.c.) increases 
the secretion of the gastric and pancreatic juices and also of the 
bile, augmenting the water of the latter. It did not affect the 
salivary secretion, nor did it lead to any rapid and considerable 
evacuations from the bowels. He concludes that as a prompt 
laxative, cascara is useless, but recommends it for its effects on 
the digestive fluids, and as a cholagogue, ranks it next in effi- 
ciency to rhubarb. 

Cascara bark is a good and efficient cathartic and is highly 
useful in habitual constipation. As a cathartic, Dujardin-Beau- 
metz \ rates it between podophyllum and rhubarb. Dose of the 
fluid extract, t^x-xxx, beginning with the smallest dose three 
times a day and gradually increasing until a free morning evacua- 
tion is produced, after which the quantity should be carefully 
decreased, giving just sufficient to produce the necessary morning 
evacuation. According to Cullimore,§ cascara is well combined 
with capsicum in obstinate constipation, which obviates the 
griping and aids the action of the former. As great difference 
in action is found in many preparations of the drug, it is well to 
begin with a smaller dose on procuring a new supply. 

DRASTIC CATHARTICS. 
JALAPA JALAP. 

Jalap is the tuber of Exogonium Purga (Nat. Ord. Convol- 
vulacese), a climbing plant of Mexico, which derives its name 
from the city of Jalapa, near Vera Cruz. The tubers are im- 
ported usually entire, but sometimes in slices. . When entire, 
they vary in size and shape from a walnut to a large pear, are 

* Am. Journ. of Pharm., Feb., 1888. " An Exam, of Cascara Sagrada," by Meier 
and Webber. 

f Ejewed. Klin. Gaz., No. 35, 1884, p. 545; No. 21, 1886, pp. 418-23; No. 22, 
1886, pp. 444-51. \ " Les Nouvelles Medications," 1886, p. 60. 

\ London Lancet, March, 1885, p. 502. 



344 MATERIA MEDICA ECCRITICS. 

hard and heavy — externally, brown and wrinkled, and inter- 
nally, grayish, with brown concentric rings ; they are often 
furrowed with vertical incisions, made to promote drying. They 
have a heavy, rather nauseous smell, and a sweetish, subacrid, 
disagreeable taste. They yield their virtues partly to water, 
partly to alcohol, and completely' to diluted alcohol. In the 
shops jalap is kept in the state of powder, which is of a yellow- 
ish-gray color. Its active principle is a resin, which consists 
of two portions, both of which are cathartic ; one is soft and 
soluble in ether, the remainder is the glucoside convolvulin 
(C 62 H 100 O 3 2), insoluble in ether ; it contains also gum and starch, 
which is apt to be attacked by worms, the worm-eaten pieces 
becoming thus the most active. 

Effects and Uses. — jalap is a powerful hydragogue cathartic, 
operating with great promptness, and often causing much pain. 
Rutherford found that jalap was an energetic hepatic stimulant, 
augmenting the flow of bile, which at the same time was rendered 
more watery. It also increases the secretion of the intestinal 
glands to a marked degree. In overdoses, it may produce dan- 
gerous hypercatharsis. Orfila * ascertained experimentally that 
5ij by the mouth is the fatal amount for a dog. We have met 
with no fatal cases in man. It is employed as a hydragogue in 
dropsy of cardiac or renal origin, when it is often combined with 
cream of tartar; as a revulsive in cerebral and other affections, 
and to increase the activity of calomel in bilious fever. Dose, 
gr. xv-xxx ; in combination, gr. x. Of the abstract, gr. j-v. The 
compound powder of jalap (pulvis jalapcz compositus) contains 35 
parts of jalap and 65 parts of cream of tartar; dose, gr. x-5j. The 
resin is extracted by solution in alcohol, and afterward precipi- 
tated from the tincture by water; dose, gr. iv— viij. 

BRYONIA BRYONY. 

Bryonia is the root of Bryonia alba and B. dioica {Nat. Ord. 
Cucurbitaceae), climbing perennial vines, growing in the thickets 
and hedges in various parts of Europe, with rough, five-lobed, 
toothed, alternate leaves and cymes of three or four small green- 
ish flowers, and black or red berries containing six large spotted 

* " Toxicologic Generale," t. I, p. 683. 



CATHARTICS PODOPHYLLUM. 345 

seeds. The root is found in the shops in transverse sections 
about two inches in diameter, with a grayish-brown, rough, thin 
bark, the central portion being whitish, with small woody 
bundles arranged in circles, and projecting, radiating lines. It is 
without smell, but has a bitter taste. The active principle is 
probably bryonin (C 48 H 80 Oi 9 ), a bitter glucoside. 

Effects and Uses. — Bryonia is a powerful hydragogue cathartic, 
resembling jalap in its action, but much more violent. It also 
acts on the kidneys, increasing their secretion. In large doses 
it has produced fatal gastro-intestinal inflammation. Christison * 
records a fatal case following the swallowing of two glasses of an 
infusion (strength not stated), which was characterized by violent 
tormina and purging. Should symptoms of its irritant action 
appear, the drug should be discontinued and opiates and stimu- 
lants administered. In dropsies it may be used as a drastic 
cathartic, with a view of also acting on the kidneys. Phillips 
recommends it in the stage of effusions in pleuritis and pericar- 
ditis, in pleuro-pneumonia, and where the joints are stiff and 
painful from rheumatic affections. The tincture is the only offi- 
cinal preparation ; dose, f 5ss-j or more. 

PODOPHYLLUM. 

Podophyllum peltatum, May-apple or Mandrake {Nat. Ord. 
Berberidaceae), is a very common indigenous herbaceous plant, 
with a long, creeping, perennial root, and an upright stem about 
a foot high, separating at the top into two petioles, each support- 
ing a large peltate leaf, divided into five or six lobes. At the 
fork of the petioles it bears a single flower, which appears in 
May, the fruit ripening in September. The rhizome and root- 
lets are the parts used. The rhizome is found in the shops in 
wrinkled, jointed, cylindrical pieces, about two lines in diameter, 
of a brown color externally, and yellowish within, having a tuft 
of about ten nearly simple fragile rootlets on its under surface. 
The powder is yellowish-gray, and has a sweetish smell ; its 
taste is at first sweetish, afterward bitter, acrid and nauseous. 
Diluted alcohol is the best solvent of podophyllum, which has 
been found to contain two resinous cathartic principles ; one 

* " A Treatise on Poisons," 4th edition, p. 594. 



346 



MATERIA MEDICA ECCRITICS. 



neutral, the other acid in reaction (podophyllinic acid). Accord- 
ing to V. Podwissotzki, of Dorpat, podophyllum and podophyllin 
both contain a resinous, bitter, amorphous substance, which is 
very active and which he calls podophyllotoxin. This consists of 
two principles, picropodophyllin (crystalline, bitter) and podo- 
phyllinic acid (inert). Power * has shown that the rhizome con- 



Fig. 30. 




PODOPHYLLUM PELTATUM. 



tains no berberine nor any other alkaloid, and his investigations 
have been confirmed by Maisch. 

Effects and Uses. — Podophyllum is therefore an active hydra- 
gogue cathartic, with an especial determination to the upper 



* Proceedings Am. Pharm. Assoc, 1 87 7, p. 420. " On the Resin of Podophyllum 
Peltatum." 



CATHARTICS CHELIDONIUM. 347 

portion of the alimentary canal, and a pretty decided cholagogue 
action which, according to Rutherford, is due to stimulation of 
the hepatic secreting apparatus, and is greater when purgation 
is not profuse, and vice versa. He also concludes that purgation 
is due to intestinal irritation, which is essentially the conclusion 
reached by Anstie.* As a cholagogue and purgative, one of the 
following pills may be given at bedtime : Jfy Resinae podophylli, 
gr. ij ; extracti colocynthidis compositi, gr. xxiv; extracti bella- 
donnas, gr. iij. M. Ft. pil. xij. It is an ingredient in several 
cathartic nostrums. Dose, in powder, gr. xx ; of the abstract, 
gr. \-) ; of the fluid extract, t^x-xx; of the extract (alcoholic), 
gr. v-xv ; of the resin, gr. \-]. 

Podwissotzki found that the effects of podophyllum depended 
upon picropodophyllin, small doses of which caused purging while 
large doses produced vomiting. 

As this is very expensive when pure, he recommends a I per 
cent, solution of podopliyllotoxin in alcohol, which he gives in 
doses of gtt. xxx in wine. 

He uses it in chronic constipation from sluggishness or atony 
of the muscular fibres, and in catarrhal jaundice. When podo- 
phyllotoxin is given internally, a cathartic effect is produced in 
about four hours ; if given hypodermically, in about two hours. 
Dose, for a child, gr. x \ ^ ; for an adult, gr. \-\, once or twice 
a day ; eight or ten hours should elapse before the second dose 
is taken. 

CHELIDONIUM 

Chelidonium majus, known also as Celandine or Tetterwort 
(Nat. Ord. Papaveraceae), is a perennial herb growing in waste 
places, indigenous to Europe, but naturalized in North America. 
The stem is about two feet high, and hairy; the leaves are 
alternate, the upper ones sessile, light-green above and glaucous 
beneath, lyrately pinnatifid, the pinnae ovate-oblong, obtuse, 
coarsely crenate or incised. The flowers appear from May to 
September, are of a bright golden-yellow color, and arranged in 
small axillary umbels on long peduncles. Chelidonium contains 

* Med. Times and Gazette; Vol. I, pp. 326,487; "Report on the Phys. Action 
of Podophyllin." 



348 MATERIA MEDICA ECCRITICS. 

two alkaloids, chelerythrine (Ci 9 H 17 N0 4 , not identical* with san- 
guinarine) and chelidonine (C ]9 H 17 N 3 03), combined with chelidoninic 
acid, which is identical f with succinic acid. 

Effects and Uses. — The physiological action of this drug has not 
been investigated. It has been used as a hydragogue cathartic, 
and is said to possess narcotic properties. Binz and Phillips both 
believe that it has a stimulating effect upon the hepatic secretions, 
and class it with podophyllum and iris. Dose of the powder, gr. 
x-5j ; or it may be given in extract or infusion. There are no 
officinal preparations. 

IRIS. 

The rhizome and rootlets of Iris versicolor, or Blue-flag 
{Nat. Ord. Iridaceae), are used as a powerful hepatic stimulant. 
The Blue-flag is found in the swampy meadows of North Amer- 
ica, having sword-shaped leaves and a stout stem, bearing a 
few blue flowers, appearing late in the spring. The rhizome 
is horizontal and jointed ; is long and cylindrical in its lower half, 
broad near its upper extremity/and terminated by a circular scar, 
annulated from the leaf-sheaths, of a grayish-brown color, with 
long: rootlets crowded near the broad end. It has a slight odor 
and a nauseous, acrid taste (Maisch). It contains a resin, to which 
probably its medicinal qualities are due. 

Effects and Uses. — In large doses the fresh plant causes violent 
vomiting and purging, with much depression : in smaller doses it 
is a cholagogue and diuretic (Phillips). The qualities are impaired 
by drying. Rutherford found that iridin (an impure oleo-resin) 
was a powerful hepatic stimulant, producing less intestinal irrita- 
tion than podophyllin, but greater purgation than euonymin. It 
was also a decided stimulant to the intestinal glands. It is highly 
recommended in jaundice of malarial origin, and may be given 
with advantage in torpidity of the liver, dropsy and intestinal 
disorders. The fluid extract (extractum iridis flidduni) may be 
given in doses of ^xx-f 5j. An extract is also officinal. 

EUONYMUS. 

Euonymus or Wahoo is the bark of Euonymus atropurpureus 
{Nat. Ord. Celastracece), a handsome shrub of the northern and 

* Pharm. Zeitung, Berlin. 1886, p. 577 ; also Journ. de Med. de Chir. et de Pharm., 
Bruxelles, 1868, p. 268. f Per. der. deutsch. chem. Ges., 1886, xv, p. 704. 



CATHARTICS SCAMMONY. 349 

middle portions of the United States, found in shady woods. 
" Its branches are slightly quadrangular ; the leaves opposite, 
petioled, elliptic-ovate, serrate, and pointed ; the flowers dark- 
purple, in loose cymes of three to six, and appear in June." 
The fruit matures in autumn, and consists of pendulous capsules 
of a bright crimson color. The bark, as seen in the shops, is of 
a grayish color, mottled with blackish patches on its outer sur- 
face, which is detached in thin and small scales ; inner surface 
tawny and smooth. It is without smell, and has at first a sweet- 
ish taste, which afterward becomes bitter and acrid. It contains 
a bitter principle, euonymin, resins, euonic acid, etc. 

Effects and Uses. — Euonymus is an excellent cathartic, increas- 
ing the intestinal secretions to some extent, and acting as a 
powerful hepatic stimulant. It may be advantageously used in 
cases of torpor of the liver and intestines. The extract is the 
only officinal preparation ; dose, gr. iij-v. 

SCAMMONIUM SCAMMONY. 

Scammony is a resinous exudation from the root of Con- 
volvulus Scammonia (Nat. Ord. Convolvulaceae), a twining plant 
of Syria. The finest kind is the product of exudation from the 
sliced root; but most of the drug which reaches us is probably 
obtained by expression, or by evaporation of a decoction of the 
root. It comes from the Levant. Genuine scammony, termed 
Virgin Scammony, occurs in light, irregular, friable pieces, of 
various shades of color, from dark-ash to dark-olive, covered 
with a whitish-gray powder, and breaking with a bright-greenish 
fracture ; they should not effervesce with an acid. The scam- 
mony of the shops, which is always more or less adulterated, is 
in hard, heavy, saucer-shaped cakes, from four to six inches in 
diameter (sometimes broken into pieces), of a dark -ash or slate 
color. The powder is light-gray ; the smell disagreeable, like 
that of old cheese, the taste at first feeble, afterward bitterish and 
acrid. Scammony is a gum-resin, the resin constituting from 80 
to 90 per cent, of the weight of good scammony, and called 
scammonin (C 34 H 56 16 ). It is a colorless and tasteless substance, 
having a peculiar faint, sweetish smell, and being soluble in 
alcohol and ether. 

A factitious scammony made in France, and known as Mont- 



350 MATERIA MEDICA ECCRITICS. 

pettier Scammony, is occasionally imported into the United States. 
It is blacker than the genuine article, has a feeble balsamic odor 
and a very bitter, nauseous taste. 

Effects and Uses. — Scammony is an energetic Jiydragogue 
cathartic, operating sometimes with great violence, and seldom 
given except in combination with other cathartics. We have 
seen no recorded fatal cases of poisoning by scammony ; Orfila* 
ascertained that so much as 5iv in dogs only produced diarrhoea. 
Dose, gr. v-xv of the pure drug, gr. x-xxx of the drug of the 
shops ; of the resin, gr. iv-viij. Scammony resin is of pleasanter 
smell and taste than jalap resin, produces less griping, and is less 
apt to cause vomiting. It is much used in the form of compound 
extract of colocynth. 

COLOCYNTHIS — COLOCYNTH. 

Colocynth is the fruit (deprived of its rind) of Citrullus Colo- 
cynthis or Bitter Cucumber (Nat. Ord. Cucurbitaceae), an annual 
plant of the south of Europe and parts of Asia and Africa, 
resembling the common watermelon. The fruit has a thin but 
hard rind, but is peeled and dried for exportation, and comes to 

Fig. 31. 




COLOCYNTH (PEELED). 

us from the Levant. It consists of light, whitish, spongy balls, 
about the size of a small orange, filled with numerous seed. For 
medicinal use the pulp only is employed, and the seed, which are 
inactive, are rejected. The pulp has a feeble odor and a nause- 
ous, intensely bitter taste. It yields its virtues to both water and 
alcohol, and contains a peculiar glucoside termed colocynthin 
(C 56 H 84 023), resin, colocynthitin, etc. 

*" Toxicologie Generale," Vol. I, p. 758. 



CATHARTICS GAMBOGE. 35 I 

Effects and Uses. — Colocynth is a hepatic stimulant, increasing 
the amount of the biliary constituents as well as rendering the 
bile more watery and at the same time stimulating the intestinal 
glands (Rutherford). It is a violent hydragogue cathartic, acting 
sometimes very harshly even in small doses, and in overdoses 
producing dangerous, and occasionally fatal, enteric inflammation. 
Christison * describes a case in which a teaspoonful and a half of 
the powder killed a man, while Husemanf mentions an instance 
in which 5^ proved fatal to a woman, and of recovery after 
swallowing 5"j. Its chief use is to unload the bowels in obsti- 
nate constipation. The dose is gr. v-x. It is seldom, however, 
administered alone. The extract (alcoholic) is used chiefly in 
the preparation of the compound extract, which contains also 
aloes, resin of scammony, cardamom and soap ; this is a favorite 
prescription, but it is apt to gripe, and it is well to combine some 
aromatic with it, as a little oil of cloves or capsicum ; dose, gr. 
v-x. 

CAMBOGIA GAMBOGE. 

Gamboge is a gum-resin procured from Garcinia Hanburii 
(Nat. Ord. Guttiferae), a tree of Siam and Cochin- China. The 
juice is collected in a bamboo joint as it exudes from a spiral 
incision in the bark, extending nearly round the tree, and is 
afterward reduced to a solid consistence by the aid of heat. 
The sap exudes slowly for several months, and the tree is not 
injured by the process. It is imported from Canton and Calcutta, 
and occurs in cylindrical rolls from one to three inches in diam- 
eter, of an orange color, known as pipe gamboge, or in irregular 
masses (which are less pure), weighing two to three pounds or 
more, called cake or lump gamboge. Good gamboge is opaque, 
brittle, inodorous, nearly insipid, and breaks with a vitreous 
fracture; its powder is bright-yellow. It is a gum-resin, forming 
a yellow, opaque solution with water and a golden yellow solu- 
tion with alcohol ; it contains from 20 to 25 per cent, of gum 
and from 75 to 80 per cent, of a resin termed cambogic acid 
(C20H23O4). 

Effects and Uses. — Gamboge is a powerful hydragogue, and in 



* " A Treatise on Poisons," 4th ed., p. 595. 
•j- " Handbuch der Toxicologic," p. 625. 



352 MATERIA MEDICA ECCRITICS. 

overdoses has proved fatal. Sometimes it causes vomiting, and 
in large amounts has produced death merely from depression. 
Christison * mentions a case in which 5j proved fatal, the symp- 
toms being excessive vomiting, purging and faintness. It is 
employed in obstinate constipation ; in dropsies, combined with 
cream of tartar or jalap ; and has been given to destroy taenia. 
Dose, gr. ij-vj. It is usually prescribed with other and milder 
cathartics, to promote and accelerate their action. Compound 
cathartic pills (pilulce catharticce compositce) are made by mixing 
compound extract of colocynth (gr. 130), extract of jalap and 
calomel (of each, gr. ico), and gamboge (gr. 25), with water, 
forming a pilular mass, to be divided into 100 pills. Three of 
the pills, containing gr. io|-§- of the mass, represent gr. 3.9 of 
compound extract of colocynth, gr. 3 of extract of jalap and 
calomel each, and gr. ^ of gamboge. 

ELATERINUM ELATERIN. 

Elaterin (CaoH^Os) is a neutral principle extracted from 
elaterium, a substance deposited by the juice of the fruit of 
Ecballium Elaterium, or Squirting Cucumber (Nat. Ord. Cucur- 
bitacese), an annual vine of the south of Europe, now cultivated 
in England. The fruit has the shape of a small oval cucumber, 
and, when fully ripe, separates from the peduncle, and throws 
out its juice and seeds with considerable force, through an open- 
ing in the base. Pure elaterium is obtained by slicing the fruit 
and allowing the juice to drain through a sieve. The juice 
deposits a sediment, which dries in very light, thin, nearly flat, 
pulverulent, greenish-gray cakes, and is the genuine elaterium. 
It is almost inodorous, and has a bitter, acrid taste. The com- 
mercial elaterium, which is obtained chiefly from England, is 
made by expression. The drug is to be considered inferior when 
it is dark-colored, much curled, and hard. Elaterium yields its 
virtues to alcohol and not to water. Elaterin, its active principle, 
crystallizes in beautiful colorless, needle-shaped crystals, without 
smell, but of a bitter, sharp taste, insoluble in water, but readily 
soluble in alcohol. 

Effects and Uses. — Elaterium is a hydragogue cathartic of great 

* "A Treatise on Poisons," 4th ed., p. 603. 



CATHARTICS CROTON OIL. 353 

violence of operation, possessing some diuretic action, and irt 
overdoses has frequently proved fatal. Beck * mentions a case in 
which extract of elaterium, gr. ij J-, with gr. xvj of rhubarb caused 
death, the chief symptoms being incessant vomiting and purging. 
It is a very efficient remedy in the treatment of dropsies, and is 
also a useful revulsive in cerebral affections ; but in administering 
it, considerable caution is required. Elaterin proves powerfully 
cathartic in doses of gr. xo~rV- 

Trituration of elaterin (trituratio elatermi) consists of elaterin 
IO parts and sugar of milk 90 parts, thoroughly triturated ; dose, 
gr. J-j. It is safest to begin with the smaller dose. 

OLEUM TIGLII CROTON OIL. 

Croton oil is a fixed oil obtained from the seeds of Croton 
Tiglium (Nat. Ord. Euphorbiaceae), a small tree of the East Indies. 
The croton seeds resemble the castor seed in shape and size, and 
consist of a blackish shell, sometimes covered with a yellowish- 
brown epidermis, and inclosing a yellowish oily kernel. They 
are highly irritant and cathartic, but are not imported into this 
country. They contain a volatile oil, a fixed oil, resin, acetic, 
butyric, and valerianic acids, together with an acid termed tiglinic 
(C 5 H 8 2 ). The croton oil of the shops is obtained by expres- 
sion, and is a mixture of the fixed oil proper, the resin and tiglinic 
acid. According to Senierf the vesicating principle resides in 
the non-volatile fatty acids, or in that part of the oil soluble in 
alcohol. The oil is made in both India and England, the Indian oil 
being of a pale straw color, and the English reddish-brown ; the 
latter is the variety now found in the shops. It has a viscid con- 
sistence, which is increased by age, a faint, peculiar odor and an 
extremely acrid, pungent taste ; it is soluble in ether and the 
volatile and fixed oils, and partially so in alcohol. The drastic 
principle has been found by Senier {loc. eit.) to exist in that por- 
tion of the oil insoluble in alcohol, which he styles the " Alcohol 
non-soluble, non-vesicating oil." This he determined experi- 
mentally to be purgative in "^ tV~2> ms work being confirmed 
by Dr. Meek (same article as Senier's). There are no exact 

* " Med. Jurisprudence," 6th ed., 11, p. 578. 
f The Pharm. Journ. and Trans., 1883, p. 446. 
23 



354 MATERIA MEDICA ECCRITICS. 

chemical tests by which croton oil can be recognized in medico- 
legal cases. 

Physiological Effects. — Croton oil, taken internally, is a powerful 
hydragogue purgative, occasionally increasing also the secretion 
from the kidneys. Gtt. j-ij are usually sufficient to produce 
active catharsis, but sometimes as much as gtt. viij-x may be 
taken without affecting the bowels. It operates very speedily, 
often causing evacuations in half an hour, and is apt to produce 
considerable sedation of the vascular system. In overdoses it 
has frequently proved fatal, destroying life rather by its depress- 
ing influence on the functions of organic life through the nervous 
system than by a local irritant action. The fatal quantity varies 
widely, since ^ iij killed a child aged 13 months,* while recovery 
has followed after swallowing f5j (a child f), and in adults f5j,t 
f 5ij % (without purging) and f §j.§ Rubbed on the skin, croton oil 
causes rubefaction and a pustular or vesicular eruption; and 
rubbed over the abdomen it will sometimes purge. 

Medicinal Uses. — Croton oil, from the smallness of the dose 
required and the speediness of its action, is an extremely valuable 
purgative in obstinate constipation, and in cerebral disorders, par- 
ticularly apoplexy. As a counter-irritant, it has been employed 
in pulmonary and laryngeal affections, diseases of the joints, etc. 
Dose, gtt. j-ij, made into pill with bread-crumb. For external 
use, it may be diluted with one or two parts of olive oil or oil of 
turpentine. 

MERCURIAL CATHARTICS. 

The preparations of mercury employed as cathartics are calo- 
mel and blue pill. Their purgative effects depend partly on the 
increased flow of bile which they occasion, and partly on the 
stimulus which they give to secretion from the mucous follicles 
of the intestinal canal and from the pancreas. They probably do 
not increase the amount of bile secreted, but by irritation of the 
orifice of the duct, cause reflex contraction of the ducts and the 
gall-bladder, and consequently expulsion of that already secreted. 

* Med. Times and Gazette, 1870, I. 

ff" Handbuch der Toxicologie," Huseman, p. 443. 

% Am. J. Med. Sci., April, 1874, p. 416. 

\ Boston Med. and Surg. Journ., 1868, p. 294. 



CATHARTICS ENEMATA. 355 

They are rarely employed alone, owing to the slowness and 
uncertainty of their action, but are usually combined with or 
followed by other cathartics (as jalap, senna, rhubarb, compound 
extract of colocynth, or some of the saline preparations). The 
mercurial cathartics are usually administered with a view of com- 
bining a purgative action with an effect on the secretions, partic- 
ularly that of the liver; also as anthelmintics and as revulsives in 
cerebral and other affections. They are well adapted to infantile 
cases, from the facility of their administration, and are especially 
beneficial in the ephemeral febrile attacks to which children are 
subject ; they, moreover, rarely produce salivation in children. 

Hydrargyri Chloridum Mite {Mild Chloride of Mercury, 
or Calomel). (Noticed at length under the head of Alteratives)) 
Dose, as a cathartic, gr. j-xij, in pill or in powder, with syrup or 
molasses ; to be followed, in from four to six hours, by some 
other cathartic. Sometimes, when it is exhibited with a view to 
a full action on the liver, gr. J^-ij may be given every hour or 
two, until the whole purgative dose is taken ; or it may be admin- 
istered at bedtime, with an aperient draught the next morning. 
For children, larger doses are required in proportion than for 
adults : gr. %-v] may be given to a child from three to six years 
old. Calomel occasionally causes griping pain in the bowels, with 
bilious vomiting ; this is attributable, not to any irritant qualities 
in the medicine, but to the acrid character of the bile secreted. 
Calomel is an ingredient of the compound cathartic pills. 

Massa Hydrargyri (Mass of Mercury), commonly called blue 
pill or blue mass (see Alteratives), is analogous in its cathartic 
action to calomel, but milder and less certain. It is given in about 
the same doses and in the same combinations, etc. 

ENEMATA. 

In cases of irritability of the stomach— or with the view of 
hastening the action of cathartics taken by the mouth — or to 
remove feculent accumulations in the lower bowels — 'or to relieve 
tympanites — or for the purpose of revulsion, or the removal of 
ascarides, cathartic enemata are frequently administered, 

When it is desired simply to open the bowels mechanically, 
tepid water, flaxseed tea, or other demulcent infusion may be 
employed. The common laxative enema consists of a table- 



$6 MATERIA MEDICA ECCRITICS. 



spoonful of common salt, molasses and lard or olive oil, each, In 
two-thirds of a pint of warm water ; castor oil or Epsom salt may 
be added to increase the cathartic effect. Senna tea or some other 
cathartic infusion is often employed. Glycerin, f5ss- j, with an equal 
quantity of water, injected into the rectum, will produce, in a few 
minutes, an evacuation, usually normal in consistence. To relieve 
flatulency, oil of turpentine (foss— j, in emulsion), or milk of asa- 
fcetida (f 5ij-iv) may be given. The latter is a suitable preparation 
in infantile cases. For the removal of ascarides infusion of quassia 
makes an excellent enema. In some cases, as invagination of the 
intestines, or even in hernia, much good may be accomplished by 
the gradual distention of the bowel by means of forced enemata of 
warm water. This is accomplished by means of a long flexible 
rubber tube, one end of which is armed with a rectal tube having 
a blunt conical point and several large openings to admit of the 
free passage of the water. The other end of the flexible tube is 
attached to a large funnel, and the tube has a stop-cock upon it. 
By elevating the funnel and filling it with water, a continual stream 
can be thrown into the bowel, the force being regulated by the 
height at which the funnel is held and by the stop-cock. In this way 
from five to ten pints of water can be thrown into the bowel, filling 
the large intestine and even passing the ileo-caecal valve. The 
injection should be conducted slazvly and carefully. Several cases 
of invagination have been reported where the symptoms subsided 
under this treatment, the invaginated portion of the intestine 
having slipped back to its proper place during the distention. 
This method should not be resorted to when there is reason to 
think that sphacelus of the bowel is taking place, as it might 
result in a rupture. 



ORDER III. DIAPHORETICS. 

Diaphoretics (from diawoplw, I transpire), called also sudorifics*. 
are medicines which promote transpiration from the skin. The 
action of the cutaneous exhalants may be increased by various 
means. The mere introduction of a large quantity of fluid into 
the system will produce sweating, if the system be kept warm. 
Exercise, and a warm temperature, by determining a flow of 
blood to the cutaneous vessels, act in the same way. Nau- 



• DIAPHORETICS PILOCARPUS. 357 

seants occasion diaphoresis by relaxing the orifices of the cuta- 
neous vessels ; stimulants, by exciting them to increased secretion. 
Diaphoretics are employed therapeutically for their evacuant, 
revulsive and alterative effects, and to promote absorption. Dif- 
ferent classes of diaphoretics are required for different morbid 
conditions. 

i. Nauseating Diaphoretics. — Most of the emetics, in nauseating 
doses, produce a powerfully relaxing diaphoretic action, and are 
much employed, with this view, in inflammatory cases, when not 
contra-indicated by the presence of gastric irritability. The Pre- 
parations of Antimony (see p. 241) and Ipecac (see p. 312) are 
chiefly resorted to as nauseating diaphoretics. Ipecac is often 
given as a diaphoretic, in combination with opium, in the form of 
Dover's Powder (see p. 82). 

2. Refrigerant Diaphoretics. — The saline and ethereal prepara- 
tions classed as refrigerants (see p. 247), produce a gentle relax- 
ing diaphoretic action, unattended with nausea. They are used 
to allay febrile excitement and reduce the temperature of the 
body. 

3. Stimulating Diaphoretics. — This group includes the diffu- 
sible stimulants, aromatic substances generally, of every class, 
and many narcotics, particularly opium and camphor. They 
are contra-indicated in high inflammation, but are very serviceable 
in rheumatic and pulmonary affections, after vascular excitement 
has been reduced, and in all diseases where the surface of the 
body is cold. Opium, in the form of Dover's Powder, may be 
employed in inflammatory cases, where other stimulating dia- 
phoretics are inadmissible, and is given with advantage in an 
early stage of acute rheumatism, dysentery and catarrh of the 
air passages, unless the action of the pulse, be very strong, when 
this should be previously moderated. The operation of the 
diaphoretic stimulants is promoted by the free use of warm 
diluent drinks, and warm covering to the body. 

PILOCARPUS. 

Pilocarpus is the leaflets of Pilocarpus pennatifolius (Nat. 
Ord. Rutaceae), a shrub of some of the northern provinces of 
Brazil, growing to the height of about five feet, with a long 
cylindrical root, about three-quarters of an inch in thickness, 



35» 



MATERIA MEDICA — ECCRITICS. 



and imparipinnate leaves (with anastomosing veins near the mar- 
gin) about nine inches long, with from three to five pairs of 
opposite, oblong-lanceolated, grayish-green leaflets, with an odd 
terminal one, which are dotted with a number of pellucid glands. 
There are several plants known in South America under the 
name of Jaborandi, and the variety brought here is from Per- 
nambuco. The leaflets have a characteristic odor (resembling a 
mixture of Indian hemp, matico and cubeb) and a warm, sharp, 
aromatic taste. They yield pilocarpine (C n H 16 N 2 2 ), an alka- 
loid of a bitter, nauseous, astringent taste, soluble in water, alco- 
hol, ether, chloroform and diluted acids, and an amorphous 



Fig. 




PILOCARPUS PBNNATIFOLIUS. A, LEAF; B, C, FLOWERS. 

alkaloid termed Jaborine* — probably a derivative of pilocarpine — 
has been isolated, which resembles atropine in action ; they con- 
tain also a volatile oil (chiefly pilocarpine, C 10 H ]6 ). Recently 
MM. Hardy and Calmelsf have obtained pilocarpine synthetically 
from a derivation of pyridin, which is stated to be identical in 
action with the natural base. 

Physiological Effects. — The action of pilocarpus and of its 
alkaloid (upon which its effects depend) has been studied by 



* Arch.filr exper. Pathol, u. Pharmakol., XII, p. 366 ; Harnack und Meyer, 
f Compt. Rend. CII, quoted in Dublin M. J., Dec, 1887. 



DIAPHORETICS PILOCARPUS. 359 

Ringer,* Murrell, Langley,f Harnack and Meyer {loc. cit), and 
many others, with the following results. It paralyzes the vaso- 
motor nervous system, and rapidly excites the circulation, 
but the pulse is soon slowed and the arterial tension is greatly 
increased. According to Ringer (loc. cit.), it paralyzes the ven- 
tricles separated from the auricles by a direct action. The tem- 
perature, as a rule, rises at first, but coincident with the profuse 
sweating, is lowered. It is a powerful diaphoretic, augmenting 
both the watery and solid ingredients of the sweat enormously, 
probably by a direct action on the peripheral endings of the 
nerves. The amount of urea eliminated by the skin is especially 
heightened. The sweat is said to be acid at first, becoming neutral 
and, finally, alkaline. It also causes salivation, which is some- 
times very profuse, in which case the diaphoretic effect is less 
marked, and vice versa. The sialagogue effect probably depends 
on a direct action of the drug upon the glands. The gastric and 
bronchial secretions are also increased. These effects continue 
for from three to six hours. Disturbance of the vision, con- 
tracted pupils, uneasiness of the head, and after a time vomiting, 
generally accompany these eccritic results, often followed by 
drowsiness. In much of its action, especially on the secretions, 
an antagonism exists between pilocarpus and belladonna (Lang- 
ley, loc. cit.). Pilocarpus appears to stimulate the nutrition of 
the hair, and in one case, Prentiss,J under its use, noticed a 
change in the color of the hair from blonde to black. Gale- 
zowski § found that an aqueous solution of pilocarpine nitrate 
applied to the conjunctiva contracted the pupil. It is eliminated 
by the secretions on which it acts. 

Medicinal Uses. — Pilocarpus should not be given in affections 
of the gastro-intestinal mucous membrane, nor in weak heart due 
to disease of the cardiac muscle or ganglia, or of the valves. In 
cases of pleuritic effusion, especially after the subsidence of the 
inflammatory symptoms, pilocarpus or its alkaloid often quickly 
removes the transudation. In renal dropsy and in uraemia it is 
often invaluable on account of its diaphoretic effects and because 



* Practitioner, 26, 1 88 1, p. 5. f Journ. of Physiology, 1878, p. 339. 

\ Phila. Med. Times, July 2d, 1 88 1. 

\ " Compte Rendus de la Societe de biologie," 4, 1877, p. 401. 



360 MATERIA MEDICA ECCRITICS. 

it increases the elimination of urea by the skin. It has also been 
used with success in puerperal convulsions due to kidney dis- 
ease, in humid asthma and bronchorrhcea, in some cases of paro- 
titis, in chronic enlargement of the cervical glands, in adenitis of 
the inguinal glands, and as an agent to increase the secretion of 
milk. Pilocarpine has been found useful in arresting severe and 
prolonged hiccough, in doses of gr. J hypo^dermically employed. 
It is recommmended in polyuria and in squamous affections of 
the skin, and has been used locally and hypodermically with 
success in alopecia. In diphtheria it has been used with varying 
success, but on the whole the evidence can scarcely be con- 
sidered in favor of its employment. Dose of the fluid extract, 
f5ss— j ; of pilocarpine hydrochlorate, gr. J-ss. Children bear pro- 
portionally large doses. 

ALTERATIVE DIAPHORETICS. 

Under this head are comprised a class of diaphoretic medicines 
which produce a gradual and nearly insensible increase of the 
cutaneous secretion, and are supposed to promote the elimination 
of noxious matters from the blood through the vessels of the 
skin. They are employed chiefly in chronic rheumatic and 
cutaneous affections, and in secondary syphilis. 

SARSAPARILLA. 

The name of Sarsaparilla is applied to the root of Smilax 
officinalis, S. medica and other species of Smilax {Nat. Ord. 
Smilaceae), twining prickly shrubs of Mexico, Guatemala and the 
warm countries of South America. The roots consist of numer- 
ous wrinkled, slender pieces, of the average thickness of a writing 
quill, several feet long, springing from a common head or rhi- 
zome, and are frequently found in the shops with portions of the 
stem attached. Several varieties are known : I. Honduras sar- 
saparilla, the most common variety in the United States, is com- 
posed of several long, thin roots, folded lengthwise, of a dirty 
grayish or reddish-brown color. 2. Jamaica sarsaparilla, which 
comes in shorter bundles, and is known by the red color of the 
epidermis. 3. Vera Cruz sarsaparilla consists of a head with 
numerous long radicals. 4. Brazilian or Rio Negro sarsaparilla 
is found in cylindrical bundles, with fewer rootlets than the Hon- 



DIAPHORETICS SARSAPARILLA. 36 1 

duras variety ; it is distinguished by the amylaceous character of 
its interior structure. 5. Guatemala sarsaparilla resembles the 
Brazilian. 

Sarsaparilla roots are several feet in length, about the thick- 
ness of a goose-quill, cylindrical, more or less wrinkled longi- 
tudinally, and consist of a whitish-brown or pink cortical portion 
covered with a thin, gray, brown or red epidermis, and inclosing 
a layer of whitish ligneous fibre and a central pith. The cortical 
portion is more active than the inferior portion ; the central 
medulla contains a good deal of starch. Sarsaparilla, in the 
dried state, is nearly inodorous, but its decoction has a strong 
smell. It has a mucilaginous, slightly bitter taste, and when 
chewed for some time produces a persistent acrid impression on 
the mouth ; this acridity of taste is the criterion of good sarsa- 
parilla. Water and diluted alcohol extract its virtues. It con- 
tains a glucoside, resembling saponin, called smilacin or parallin, 
a volatile oil, starch, mucilage, resin, extractive, etc. The Vera Cruz 
and Jamaica varieties contain the most smilacin, and are there- 
fore the best for medical purposes. 

Effects and Uses. — The physiological effects of sarsaparilla, 
beyond a slight diaphoretic action, are not very obvious ; in large 
doses it occasionally produces nausea and vomiting. Its efficacy 
in eradicating various morbid symptoms is believed in by some, 
though denied by others; and its mode of action, though obscure, 
is popularly attributed to a purifying influence on the blood 
through the function of the skin. It is employed in tertiary 
syphilis, particularly where the disease resists or is aggravated 
by the use of mercury ; also in chronic rheumatism, skin dis- 
eases, and cachectic conditions of the system generally. 

Administration. — Dose, of the powder, 5ss three or four times 
a day — never used, however, in this form. The compomid decoc- 
tion is made by boiling sarsaparilla 10 parts, sassafras, guaiacum 
wood and liquorice root each 2 parts, and mezereon 1 part, in 
IOO parts of water, then macerating, and, after straining, adding 
water enough to make the decoction measure 100 parts ; dose, 
f5iv-vj t. d. The compound syrup (which contains also guaiacum 
wood, pale rose, senna, glycyrrhiza, sassafras, anise, and gaulthe- 
ria) is a favorite preparation ; corrosive sublimate should riot be 
given with it, as it is decomposed into calomel. Dose, f §ss. Of 



362 MATERIA MEDICA — ECCRITICS. 

the fluid extract \ the dose is f5ss. The compound fluid extract 
contains the ingredients of the compound decoction, except the 
guaiacum ; dose, f 5j, repeated. 

GUATACI LIGNUM— GUAIACUM WOOD. 
GUAIACI RESINA GUAIAC. 

Guaiacum Wood, or Lignum Vitcz, and Guaiac are products of 
Guaiacum officinale and G. sanctum {Nat. Ord. Zygophyllaceae), 
large evergreen trees of South America and the West Indies. 
The wood, which is remarkable for its hardness and density, is 
imported in logs or billets, covered with a thick gray bark ; the 
outer portion or sap-wood is of a pale-yellow color, the inner of 
an olive-brown. The heart- wood is the officinal portion ; it is 
usually kept in the shops in the state of shavings or raspings ; 
they are inodorous unless heated, and when chewed for some 
time they have a bitterish pungent taste. Guaiacum wood yields 
its virtues to alcohol, and partially to water ; they depend on the 
guaiac contained in the wood. 

Guaiac is a peculiar resin, obtained from Guaiacum officinale 
by spontaneous exudation, by incision, by dry heat, or by decoc- 
tion of the comminuted wood. It comes in large, irregular, 
semi-transparent, brittle pieces, of varying size — externally of a 
deep green or olive color, and internally red. It has a slight 
balsamic odor, which is rendered stronger by heat, and though 
at first nearly tasteless, leaves a hot, acrid sensation in the mouth 
and throat. Water dissolves it partially, alcohol completely. 
It contains guaiaconic and guaiaretic acids, guaiac beta-resin, 
gum, ash, guaiacic acid, coloring matter, etc. (Hadelich *). Most 
oxidizing agents, as nitric and chromic acids, etc., produce 
a blue, then green, and finally a brown color, with tincture of 
guaiacum. 

Effects and Uses. — Guaiacum wood and guaiac are stimulant 
diaphoretics, also increasing the secretion of bronchial mucus, 
and in large doses cathartic. They are principally used for their 
alterative virtues in chronic rheumatism and skin diseases ; 
guaiac has been used as a laxative. In tonsillitis the tincture, 
f5/^, repeated every three or four hours, is extremely useful. 

* " Pharmacographia," 2d ed., p. 104, quoted. 



DIAPHORETICS MEZEREUM. 363 

They are considered also to possess emmenagogue properties, 
and are employed in amenorrhcea and dysmenorrhcea. 

Administration. — Gitaiacnm wood is used only as an ingredient 
in the compound decoction and syrup of sarsaparilla. Dose of 
guaiac, gr. x-xxx, in pill or emulsion, sometimes combined with 
alkalies. The tincture (20 parts in 100 parts of the tincture) and 
ammoniated tincture (20 parts to ar. sp. of ammonia q. s. to make 
100 parts) are much used in chronic rheumatism ; the former is 
given also in amenorrhcea ; dose, f 5j t. d. They are decomposed 
by water, and should be administered in mucilage, syrup or milk. 

MEZEREUM. 

Mezereon is the bark of Daphne mezereum and other species 
of Daphne {Nat. Ord. Thymelaceae), European shrubs which 
grow to the height of four or five feet. The root-bark is the 
part employed in Great Britain, but the bark of our shops, which 
is brought from Germany, is the stem-bark. It comes in strips 
from two to four feet long and an inch or less in breadth, folded 
in bundles or wrapped in the shape of balls. It has a thin, 
grayish or reddish-brown, wrinkled epidermis and a tough, 
pliable, whitish inner bark. When fresh it has a faint, nauseous 
smell, but when dry it is nearly inodorous. Its taste is at first 
sweetish, afterward highly acrid. It yields its virtues to water 
and alcohol, and contains a neutral crystalline bitter glucoside, 
called daphnin (C 31 H340 19 ), and a resin, to which it owes its 
acridity. 

Effects and Uses. — The topical action of mezereon is irritant and 
vesicant. When swallowed in large quantities it is highly acrid ; 
in medicinal doses it promotes the action of the secreting and 
exhaling organs, particularly of the skin and kidneys. Christison* 
records a case of fatal poisoning in a child of 8 years by mezereon, 
but the quantity taken is not mentioned. It is employed chiefly 
in conjunction with sarsaparilla (in the compound decoction, etc.) 
as an alterative diaphoretic in rheumatic, syphilitic and cutaneous 
affections. As a masticatory, it has been chewed for the relief of 
paralysis of the muscles of deglutition. The fluid extract is the 
best preparation for internal administration ; dose, f^x. An extract 

* "A Treatise on Poisons," 4th ed., p. 601. 



364 MATERIA MEDIC A ECCRITICS. 

is also officinal, and is used as an addendum to rubefacient lini- 
ments and ointments. The ointment is also used as a stimulating 
application to blistered surfaces and indolent ulcers. 

MENISPERMUM. 

Menispermum is the rhizome and rootlets of Menispermum 
canadense, Yellow Parilla or Canada Moonseed (Nat. Ord. Meni- 
spermaceae), a climbing plant of North America. The rhizome 
contains berberine, starch, etc. It is supposed to be a diaphoretic, 
diuretic, tonic and alterative, and to possess virtues similar to 
those of sarsaparilla, and it maybe given in corresponding doses. 
According to the experiments of Rutherford, it is an intestinal, 
but not a hepatic, stimulant. There are no officinal preparations. 

CALENDULA. 

Calendula is the fresh flowering herb of Calendula offici- 
nalis, or Marigold {Nat. Ord. Compositae), a European plant, 
cultivated in our gardens. It contains a volatile oil, a bitter prin- 
ciple, calendidin, etc. It is supposed to be a stimulant, alterative, 
diaphoretic and diuretic. It is said to be efficacious in certain 
forms of chronic vomiting, and externally, to promote resolution 
of ulcers, wounds and contusions. It may be given in doses of 
gr. viij-5j. Of the tincture, the dose is foss-j. It may be used 
externally, diluted with water 20 parts. 

SASSAFRAS. 

This is the bark of the root of Sassafras officinale (Nat. Ord. 
Lauraceae), an indigenous tree of middling size. The bark is 
found in the shops in small, irregular pieces, of a cinnamon color, 
sometimes invested with a brownish epidermis. It has a highly 
fragrant odor and a sweetish, aromatic taste. Its virtues are 
extracted by water and alcohol, and it contains a little tannic acid 
and a volatile oil (oleum sassafras). 

Effects and Uses. — Sassafras bark is a mild stimulant alterative 
diaphoretic, used chiefly in combination with sarsaparilla. Its 
principal virtues are probably aromatic. Dose of the oil, gtt. ij-x. 
(For Sassafras Pith, see Demulcents^) 



DIURETICS. 365 

STILLINGIA. 

The root of Stillingia sylvatica (Nat. Ord. Euphorbiaceae), 
commonly called Queen's Delight, a perennial plant, growing to 
the height of two feet in our south Atlantic States, is highly 
esteemed by southern physicians as an alterative diaphoretic in 
secondary syphilis, scrofula, cutaneous affections and chronic 
rheumatism. Dose of the powder, gr. xv-xxx. The fluid extract 
may be given in the dose of f 5'ss. A decoction and tincture are 
extemporaneously prepared. 



ORDER IV. DIURETICS. 

Diuretics (from did, thoroughly ,'and oupia>„ I make water) are 
medicines which excite the secretion of urine. The flow of urine 
may be promoted indirectly by increasing the quantity of fluid 
taken into the stomach, or by the removal of causes which check 
its secretion, or by mental emotion, a cool temperature, etc. It 
is promoted directly by the use of medicinal agents which specific- 
ally affect the kidneys ; they are termed diuretics. A large pro- 
portion of diuretic medicines are found among the agents which 
influence other, secretions, particularly diaphoretics. The func- 
tions of transpiration and urination are to some extent vicarious, 
and the same articles will prove diaphoretic or diuretic, as their 
action may be directed to the skin or kidneys. External warmth 
and warm drinks determine the action of such medicines to the 
skin ; and, on the other hand, if the skin be kept cool, and cool 
diluents freely administered, the secretion from the kidneys is 
promoted. 

. Blennorrheas, or medicines which have a special action on the 
mucous membranes, exert also a diuretic influence — probably 
the result of the stimulating impression which they make- on the 
mucous membrane of the urinary passages. When the action of 
the kidneys is obstructed by diseases of the heart, sedatives prove 
diuretic, by their tranquilizing influence on the action of the heart. 
In cases of obstruction of the portal system, mercurials increase 
the efficacy of the diuretics proper ; and also cathartics y by stimu- 
lating the flow of bile and the pancreatic juice. 

The principal therapeutic employment of diuretics is to promote 
the absorption of dropsical effusions. They are also useful in 



366 MATERIA MEDICA — ECCRITICS. 

nephritic disorders attended with obstructed secretion ; to wash 
out calculi from the pelvis of the kidneys, ureters and bladder ; 
in gravel, with the view of rendering the urine more dilute ; and 
they may be resorted to as evacuants, to reduce inflammation. 

As diuretics act by becoming absorbed, they should be admin- 
istered in a very diluted state, to prevent a cathartic effect. 

The following groups of medicines, noticed under other heads, 
are employed also as diuretics : — 

1. The Saline and Ethereal Refrigerants (see p. 247). 

2. The Alkaline Carbonates (see Antacids); and the Alkaline 
Salts which contain a vegetable acid, as the acetates, citrates and 
tartrates. The acid potassium tartrate, or cream of tartar (see 
p. 334), is a very active diuretic. 

Potassii Acetas {Potassium ' 'Acetate). This salt (KC 2 H 3 2 ), 
formerly termed sal diureticus from its decided diuretic action, is 
made by saturating acetic acid with potassium bicarbonate. It 
occurs, when pure, as a white, foliaceous, satiny mass, of a warm 
pungent taste, very deliquescent, and wholly soluble in water and 
alcohol. The physiological effects of the potassium compounds 
have already been fully considered (see p. 244). In small doses 
it is diuretic, and in larger doses gently cathartic. It is a good 
deal employed as a diuretic in dropsies, as an antacid in acute 
rheumatism, as a preventive of the formation of urid acid calculi, 
and it has also been found useful as an alterative in cutaneous 
affections. As is the case with all the alkaline salts containing 
vegetable acids, the acid of this salt is decomposed in the system 
into carbonic acid. Although increasing the flow of urine, potas- 
sium acetate diminishes the amount both of uric acid and of urea 
in the secretion. Hence, it is valuable in gout, and, like colchicum, 
it may perhaps check the actual formation of uric acid in the 
system. Dose, gr. xx-3j, repeated. 

Sodii Acetas {Sodium Acetate) (NaC 2 H 3 02,3H 2 0), is prepared 
from crude pyroligneous acid, which is saturated with cream 
of lime, and the solution of calcium acetate thus formed is decom- 
posed by sodium sulphate ; repeated solution and crystallization, 
with fusion, furnish a pure salt in the form of white or colorless 
striated prisms, which effloresce in dry air, are wholly soluble 
in water, tolerably soluble in alcohol, and have a sharp, bitterish, 
not disagreeable taste. Its effects and uses are analogous to those 



DIURETICS — SQUILL. 367 

of potassium acetate, over which it has the advantage of not being 
deliquescent. Dose, gr. xx-5j, p. r. n. 

3. Sedatives (see p. 226) ; and Digitalis (see p. 268), which is 
very much employed in cardiac dropsies in combination with 
squill. 

4. Blennorrhetics (see p. 378), particularly the oleo-resins. 

5. Most of the Stimulating Diaphoretics. 

special diuretics. 

scilla squill. 

Squill is the sliced bulb of Urginea Scilla {Nat. Ord. Liliaceae), 
a perennial plant which grows on the shores of the Mediterranean. 
It has fibrous roots attached to a roundish-ovate bulb, from which 
both the leaves and flower-stem spring directly, the latter ap- 

Fig. 33. 




URGINEA SCILLA, BULB. 



pearing first ; the leaves are broad-lanceolate, and from twelve to 
eighteen inches long ; the stem is about two feet high, and bears 
pale yellowish-green flowers. 

The fresh bulb is pyriform, of the size of the fist to that of a 
child's head, and consists of thick, fleshy, concentric scales, 
attenuated at their edges, and attached to a rudimentary stem ; 
the outer scales are very thin and papery. Two kinds of squill 
bulbs are met with, the white and the red, which differ only in 
the color of their scales, and are identical in medicinal virtues. 



368 MATERIA MEDICA ECCRITICS. 

Both abound in a viscid, acrid juice, which is very much dimin- 
ished by drying, with little loss of medicinal power. For im- 
portation, squill is usually sliced and dried, and is found in the 
shops in white or yellowish-white pieces, which when dry are 
brittle, but when moist, flexible. They absorb moisture readily, 
and. should be kept in well-stoppered bottles. They have a 
feeble odor, a bitter, nauseous, acrid taste, and yield their virtues 
to water, alcohol and vinegar. The active principles found in 
squill are scillipicrin, scillitoxin, and scillin. The first two are said 
to act on the heart like digitalis, slowing the pulse by stimulat- 
ing the end-organs of the par vagum, and the last to produce 
numbness and vomiting. A principle termed scillain is described 
by Jarmersted,* which he ascertained to be poisonous to the 
heart-muscle. 

Physiological Effects. — In small doses, squill promotes secre- 
tion from the mucous membranes and the kidneys — its diuretic 
effect being much the most marked and constant. Hammond f 
found that, in addition to its diuretic action, it increased also the 
proportion of inorganic solids. Husemann states that the diu- 
retic effects of squill are due to its influence on the blood-pressure, 
which it increases ; but clinical experience teaches that it stimu- 
lates the kidneys. In larger doses it excites nausea, vomiting, 
and occasionally purging ; and in excessive doses it acts as an 
acro-narcotic poison, gr. xxiv J having proved fatal. The symp- 
toms are violent vomiting and purging, abdominal pains, bloody 
or suppressed urine, reduction of the pulse, with collapse ; or 
death may be preceded by convulsions. Christison § describes 
an instance in which a teaspoonful of the root killed a woman, 
the main symptoms being gastric pain and convulsions. The 
stomach was found to be inflamed everywhere, and partly eroded. 
After evacuation of the stomach, opiates and demulcents are to 
be administered, and, if syncope or collapse occur, alcoholic 
stimuli should be given. 

Medicinal Uses. — Squill is employed principally in the treat- 
ment of dropsy ; it should not be used, however, in cases compli- 

* Arch, fur exper. Pathol, u. Phai'??iak., XI, p. 22. 
f Am. Journ. Med. Set., 1859, p. 275. 
I " Handbuch der Toxicologic," p. 413. 
§ " A Treatise on Poisons," 4th ed., p. 879. 



DIURETICS COLCHICUM. 369 

cated with degeneration of the kidneys or inflammation of the 
bladder. Digitalis is much prescribed in combination with 
squill in the treatment of cardiac dropsies, and calomel is often 
added with a view to its action on the absorbents. As a blen- 
norrhetic expectorant, squill is an excellent remedy in chronic 
and subacute bronchial affections ; it is, however, improper in 
the early stages of inflammatory cases. As an emetic, squill is 
too dangerous for general use ; but it forms an ingredient in 
some emetic preparations administered in croup. 

Administration. — Dose, as a diuretic or expectorant, gr. j, 
repeated and gradually increased till nausea supervenes. Gr. 
vj-xij will vomit. Of the vinegar (acetum scillce, containing 10 
per cent, by weight of the powder), the dose is ^xv to f 5ij ; of 
the flidd extract, ^j ; of the syrup, f 3j ; of the compound syrup, 
known as hive syrup (which contains a solution of senega and 
squill in diluted alcohol and water, and tartar emetic, gr. j in 
every ounce of the syrup), i^v-fSj, according to the age; of the 
tincture, ^v-xxx. 

COLCHICUM. 
Colchici Radix, Colchicum Root ; Colchici Semen, Colchicum Seed. 

Colchicum autumnale, or Meadow-Saffron {Nat. Ord. Melan- 
thaceae), is a small biennial, bulbous plant, which grows wild, in 
moist meadows, in England and other temperate parts of Europe. 
The bulb, or corm, appears in midsummer as the lateral offset 
from the corm of the preceding year, and sends up the flower- 
stem in the autumn — the leaves and fruit following in the 
succeeding spring. The leaves are broadly lanceolate, about five 
inches long ; the flowers, of a lilac or light-purple color ; and the 
fruit, oblong, elliptical and three-celled. 

The corm and seed are the portions used medicinally. The 
corms are gathered in July, just before the sprouting of the 
flower from the young corm. They are somewhat like tulip- 
bulbs in appearance, but solid, and not composed of scales. 
They are covered by an external brown membrane and an inner 
reddish-yellow one, and are an inch and a half to two and a 
half inches in length, with a longitudinal groove. Internally 
they are white, fleshy and solid, and contain an acrid, bitter, 
milky juice. As found in the shops they are in the dried state, 
sometimes whole, but usually cut into transverse slices, about an 
24 



37o 



MATERIA MEDICA ECCRITICS. 



eighth of an inch thick, with a notch on one side, and deprived 
of the outer brown membrane. They have a hircine odor 
and a bitter, hot and acrid taste. The seed are brown, about 
the size of black-mustard seed, inodorous, and have a bitter, 
acrid taste ; they are less apt to be injured by drying than the 
corm. 

Colchicum corm and seed yield their virtues to vinegar and 
alcohol ; they both contain an alkaloid, soluble in water, readily 
so in alcohol, but insoluble in ether, termed colchicine (C23H27NO7, 
Laborde et Houde), on which the medicinal activity depends. 
Colchiceine (C^H^NO^) is a crystalline substance, of feeble acid 



Fig. 34. 




COLCHICUM AUTUMNALE, BULB. 



reaction, which does not preexist in the plant, but is formed by 
the action of the mineral acids upon colchicine. Colchicine 
makes with concentrated nitric acid a play of colors, beginning 
with yellow, then green, afterward crimson, and finally violet ; with 
concentrated sulphuric acid, to which has been added a fragment 
of potassium nitrate, it produces an intensely yellow color termi- 
nating in light violet. 

Physiological Effects. — Colchicum is a local irritant. Colchicine 
is undoubtedly the active ingredient of meadow-saffron (Huse- 
man*), and when introduced by the stomach diffuses into the 



*"Die Pflanzenstoffe," 1871,^?. 497. 



DIURETICS COLCHICUM. 37 I 

blood, since it has been found in the heart, lungs, liver, kidneys 
and blood by Aschoff.* Other observers, however (Laborde et 
Houdef) failed to detect it there or in the heart, even after intra- 
venous injection, but found the largest quantity inside the stomach 
and intestines. It seems to expend its force on the alimentary 
tract, though not entirely by a local action, for both LewinsJ and 
Roy§ found these parts to be much inflamed after the subcuta- 
neous administration of the drug. Taken internally, in small 
doses, it stimulates the secretions generally ; in larger doses it 
produces nausea, vomiting,|| and repeated purging, and primarily 
acceleration, followed by a reduction in the frequency of the 
pulse ; in excessive doses it is an intestinal irritant poison, inducing 
emesis, uncontrollable diarrhcea, collapse, and finally producing 
death by paralysis of respiration, the heart beating for a short 
time after the cessation of this act, the cerebral functions usually 
remaining unaffected, though Toulmouche {loc. at.) states that 
there is decided cerebral excitement. According to the recent 
investigations of Laborde et Houde (loc. cit) colchicine is without 
action on the centres of intelligence or volition, and there is an 
entire absence of paralysis, either motor or sensory, of central 
origin. The temperature falls during the period of emeto- 
catharsis; and when injected into dogs there is a marked fail 
in the blood pressure. The amount of urea and uric acid 
excreted in the urine is much increased after the adminis- 
tration of colchicum. Lewins {loc. cit) found the urea to be 
almost doubled. Hammond^f experimentally ascertained that 
it heightened the urinary flow and the proportion of solids, but 
as his results were based on only three analyses they can 
scarcely be accepted as conclusive. It increases the secretion 
of bile, which at the same time is rendered very watery. 

Fatal Quantity. — Dr. Major** reports 17 cases of poisoning by 
the wine of colchicum seeds, seven of which were fatal, the 

* "Die Pflanzenstoffe," 1871, p. 499, quoted. 

f Pamphlet, 1887. " Le Colehique et la Colchicine." 

% Edinburgh Med. and Surg. Jour., lvi, p. 185. 

\ Arch, de physiol. Norm, et Pathologique, t. V, p. 648. 

|| Arch. Gin. de Midecine, t. xviil, p. 37, par. A. Toulmouche. 

^ Amer. Journ. Med. Set., 1859, p. 275. 

** Canada Med. and Surg. Jour., 1 874, p. 24. 



372 MATERIA MEDICA ECCRITICS. 

quantity ingested ranging from fSiij-viij ; in two, there were con- 
vulsions. Dr. G. B. Wood* states that f 5iiss of the wine of the 
root proved fatal, and in another instance f oiss")* of the wine of 
the bulb killed a man. Vomiting and purging are the chief 
symptoms of colchicum poisoning, convulsions being infrequent, 
while the brain escapes till the approach of death. After death, 
in Roy's {loc. cit) experiments upon dogs, the post-mortem appear- 
ances were those of enteritis. Tannic acid is a partial antidote 
(forms a white precipitate with colchicine) ; opiates, demulcents 
and stimulants are to be given. Although placed among the 
diuretics, colchicum does not evince a more decided action on 
the kidneys than on other secretions, as those of the skin, liver 
and mucous membranes. 

Medicinal Uses. — Colchicum has long enjoyed a high reputa- 
tion in the treatment of gout ; and, although its modus medendi 
is obscure, it is universally admitted to possess a more decided 
control over the disease than any other remedy. It is usually 
administered in repeated doses till an effect is produced on the 
bowels, though purging does not promote its curative effect. 
Epsom salts and magnesia are often combined with it, as in the 
celebrated Scudamore's draught {magnesia, gr. xv-xx ; magne- 
sium sulphate j 5j-ij ; wine of colchicum seed, f5j-ij, in any 
pleasant vehicle). An excellent combination in the. treatment of 
gout is colchicum {wine of the seed, f§j), with potassium iodide 
(5ij), dissolved in cinnamon water (f§viij) ; dose, f 5ss t. d. until 
purgation is produced. Quinine and digitalis are also often given 
advantageously, with colchicum, in gout.J When it is desired 
to act on the kidneys and skin rather than the bowels, opiates 
are sometimes added. It is better to reserve colchicum for the 
treatment of the acute paroxysms of gout, giving a little opium (as 
in Dover's powder) at night, particularly to relieve the pain and 
procure sleep, enjoining perfect rest and quiet and using warm 
applications locally. In chronic gout and in lithaemia colchicum 
is not as useful, and these conditions are better treated by a 

* '•• U. S. Dispensatory," 15th ed., p. 1534. 

f Edinburgh Med. and Surg. Journ., XIV, p. 262. 

% Lartigue's celebrated gout-pills are : acetic extract of colchicum root, 2 grains; 
extract of digitalis, I grain ; compound extract of colocynth, 20 grains, to be mixed 
and divided into five pills— one to be taken at night. 



DIURETICS OIL OF ERIGERON. 373 

properly regulated diet, avoidance of stimulants, exercise in the 
open air and the administration of the alkalies, particularly of 
the lithium salts. In rheumatism it is also employed, but it has 
little control over this disease. Dr. Woodbury,* however, has 
recently reported cases where hypodermic injections of ^v of a 
solution of colchicine (y 1 ^ per cent.) gave speedy and permanent 
relief in acute rheumatism, after the salicylates had failed. 

It has been occasionally resorted to as a diuretic in dropsy, 
as a sedative in febrile and inflammatory diseases, as an anthel- 
mintic and as an expectorant. 

Administration. — Dose of the corm or seed, in powder, gr. ij- 
viij ; the seeds are to be preferred. The liquid preparations, which 
are more generally used than the powder, are : the wine of the root 
(vinum colchici radicis), ""£ x-xxx ; wine of the seed (vinum colchici 
seminis), dose, f5ss-j; tincture (of the seed), dose, f5ss— j. An 
extract of the root (acetic) is also employed — dose, gr. j-ij ; and 
a fluid extract of the seed and also of the root — doses, gtt. iv-xij. 
The alkaloid colchicine (not officinal) has been recommended as 
the best form of administration in doses of gr. -^ in pill, or 
somewhat less by hypodermic injection. 

OLEUM ERIGERONTIS OIL OF ERIGERON. 

The oil distilled from the fresh flowering herb of Erigeron 
canadense, or Canada Fleabane (Nat. Ord. Composite), an herba- 
ceous indigenous plant, two or three feet high, with ovate or 
lanceolate toothed leaves, and white, blue or purple flowers. 
The oil by distillation yields resin and turpene (C 10 H 16 — Powerf). 
It possesses diuretic and hemostatic properties, and has been used 
in hemorrhagic dysentery and uterine hemorrhage. It has also 
been used in gonorrhoea with success, Stark % stating that in 
the majority of cases it stopped the discharge in from two to six 
days. Prettyman § reports unvarying success with it in 50 cases, 
affirming that it cures in from six to eight days, but as he omits 
the details of treatment, his statement cannot be accepted as 
proven. Dose, gtt. v-xx, on sugar, or in capsule. 

* Phila. Med. Times, Dec. 2d, 1882. 
f" Pharm. Rundschau," Sept., 1887, p. 201. 
% London Med. Record, June 15th, 1886, quoted. 
. \Amer. Jour. Med. Scu, 1886, p. 117. 



374 



MATERIA MEDICA ECCRITICS. 



APOCYNUM. 

Apocynum cannabinum, or Canadian Hemp [Nat Ord. Apocy- 
nacese), is an indigenous herbaceous plant growing to the height 
of two or three feet, with oblong-ovate leaves and small greenish, 
campanulate flowers. ,The root is the officinal portion ; it is of 
a yellowish-brown color when young, and of a dark-chestnut 



Fig. 35. 




APOCYNUM CANNABINUM. 



when old, has no odor, but a nauseous, acrid, bitter taste. The 
fresh root, when wounded, pours out a milky juice, whence the 
plant is sometimes termed milk-weed. It yields its virtues to 
water and alcohol, and contains gallic and tannic acids, gum, resin, 
apocynin, apocynein y bitter extractive, etc. Although the entire root 



DIURETICS TARAXACUM. 375 

is officinal, the bark of the root is probably alone active. A. 
androsaemifolium, or Dogsbane, is possessed of much the same 
properties as A. cannabinum. 

Effects and Uses. — Canadian Hemp is diuretic, diaphoretic, seda- 
tive, and, in continued doses, emeto-cathartic. It is chiefly em- 
ployed in the treatment of dropsy, in which its action is often 
powerfully efficacious. It should be given in amounts just suffi- 
cient to produce diuresis, when a cathartic effect is not desirable. 
The best form of exhibition is an infusion (3ss to boiling water 
Oj, or the same amount may be dissolved in gin Oj) ; dose, 
f 5ij-iv three or four times a day. 

TARAXACUM. 

Taraxacum Dens-leonis, or Dandelion [Nat. Ord. Composite), 
is a small herbaceous, perennial plant, common to most parts of 
the world, and found abundantly throughout the United States. 

Fig. 36. 




TARAXACUM DENS-LEONIS. 



It has a fusiform root, which sends up numerous long, sinuated, 
bright-green leaves, and flower-stems about six inches high, 
bearing golden-yellow flowers. The root is the officinal portion, 
and should be gathered in the autumn. In the fresh state it is 
several inches long, branched, fleshy, of a light-brown color 
externally, whitish within, and abounds in a milky juice ; the fresh 
root is preferable for use. When dried it is shrunken, wrinkled 
and brittle. It is without smell, but has a bitter taste Boiling 
water extracts its virtues, which probably depend on a peculiar 



376 MATERIA MEDICA ECCRITICS. 

bitter crystallizable principle termed taraxacin, soluble in water 
and alcohol. It also contains taraxacerin, resin, and Dragendorff* 
found inulin and some sugar. 

Effects and Uses. — Taraxacum is diuretic and slightly aperient, 
with some tonic action, and a slight determination to the liver- 
It is useful in hepatic dropsies, and is also employed in dyspepsia 
accompanied by derangement of the liver. It may be given in 
the form of infusion — dose, ff>ij t. d. ; extract (an inspissated 
juice, w r hich should not be kept above a year) — dose, gr. xx-5j t. 
d. ; fluid extract — dose, f 5j-ij t. d. 

TRITICUM — COUCHGRASS. 

The rhizome of Triticum repens or Couchgrass {Nat. Ord. 
Graminaceae), a perennial weed, native of Europe and North 
America, growing in fields and in waste places, with a long, stiff, 
pale-yellow rhizome, which should be gathered in the spring, and 
is found in the shops, freed from the rootlets, cut into short 
lengths and dried, without odor, but having a slightly sweetish 
taste (Fluckiger and Hanbury), contains triticin (which resembles 
inulin), and several sugars, and appears to be a feeble diuretic. 
According to Sir H. Thompson,f couchgrass exercises a bene- 
ficial influence in cystitis. He directs the decoction to be made 
by boiling 5ij-iv in water Oij until reduced to Oj ; the strained 
liquor to be taken in four doses in 24 hours. Whitla, too, advises 
it to allay irritation of the urinary passages. Fluid extract may 
be given in doses of f5ss-j. 

JUNIPERUS JUNIPER. 

The fruit or berries of Juniperus communis {Nat. Ord. Co- 
niferse), an evergreen European shrub, naturalized in the United 
States, are used as adjuvants to the more active diuretics, and in 
large doses produce strangury and bloody urine, and prove em- 
menagogue. When dried they are about the size of a pea, of a 
blackish-purple color and a sweetish, terebinthinate, aromatic 
taste ; they are given in infusion. Their virtues depend on a 
volatile oil (oleum juniperi) (C 10 H 16 ), the dose of which is gtt. 

* " Pharmacographia," 2d ed., p. 394, quoted. 

I "Diseases of the Urinary Organs," 7th edition, p. 152. 



DIURETICS CANTHARIDES. 2>77 

v-xv two or thres times a day. Hammond * found that juniper 
increased the flow of urine, the proportion of solids being only 
slightly altered (three experiments). The compound spirit (con- 
taining also the oils of caraway and fennel, dissolved in alcohol 
and water) is a pleasant addition to stimulating diuretic and blen- 
norrhetic combinations, and a good stomachic and carminative ; 
dose, f5j-ij. The spirit is made by dissolving 3 parts of the oil 
in 97 parts of alcohol; dose, f5]-ij. An active diuretic mixture 
is : 1^ Potassii bitartratis, §ij ; seminis juniperi, Sj ; aquae (tepid), 
Oiv. M. Sig. — All to be taken in 24 hours. 

SCOPARIUS. 

Sarothamus Scoparius, or Broom {Nat. Ord. Leguminosae), is 
a common European shrub, cultivated in the United States, from 
three to five feet high, with numerous bright-yellow flowers. 
The tops of the branches are the officinal portion, but the seeds 
are also used. The twigs are pentangular (with small oblong, 
downy leaves), of a bright-green color, a strong, peculiar odor 
when bruised, and a bitter, nauseous taste. Two principles are 
found in broom-tops — scoparin (C21H22O10), a neutral, crystalliz- 
able body, supposed to be the diuretic constituent, and a volatile 
alkaloid, sparteine (C 15 H 2 6N 2 ), (vide p. 275); it also contains volatile 
oil, tannin, etc. 

Effects and Uses. — Broom is an efficient diuretic, in large doses 
producing free purging. It is a valuable and reliable remedy in 
dropsy, best given in decoction, half an ounce to a pint of water, 
boiled down to half a pint, of which an ounce may be given 
every hour or two till the bowels are disturbed. A fluid extract 
is used in doses of f 3ss-j. 

CANTHARIS CANTHARIDES. 

The properties, etc., of cantharides will be noted fully under 
the head of Irritants (subdivision Epispastics). Taken internally, 
they sometimes prove diuretic, and generally excite irritation of 
the genito-urinary passages, as strangury, priapism, etc. ; and 
in overdoses act as an acro-narcotic poison. They are em- 
ployed in dropsies, incontinence of urine, amenorrhcea, seminal 

* Amer. Journ. Med. Sci., 1859, p. 275. 



378 MATERIA MEDICA ECCRITICS. 

weakness, impotence, etc. Dose, gr. j-ij twice a day, in pill. 
They are most commonly administered in tincture (5 per cent.) ; 
dose, gtt. x or more three or four times a day till signs of 
strangury supervene. 



ORDER V. BLENNORRHETICS. 

Blennorrhetics (from pXiwa, mucus, and piw, I flow) are medi- 
cines which promote the secretion of the mucous membranes. 
They are employed therapeutically in morbid conditions of those 
membranes, with a view to the restoration of healthy action in 
cases of deficient, abnormal or excessive secretion. 

When administered with the object of stimulating the secretion 
of mucus from the bronchial or laryngeal membrane, this class of 
agents is termed expectorants. They are prescribed in the subacute 
and chronic forms of bronchitis and laryngitis, and in the declining 
stages of the acute forms of those affections and pneumonia. In 
the early or inflammatory stages of acute bronchitis and laryngitis 
the stimulating expectorants are inadmissible until expectoration 
has been established. 

The blennorrhetics are less employed in gastro-enteric affections 
than in those of other mucous membranes, owing to their 
tendency to produce catharsis. Several of the oleo-resins are, 
however, used with advantage in certain forms of chronic diar- 
rhoea, and the oil of turpentine is highly esteemed in the treatment 
of the diarrhoea of typhoid fever. 

The oleo-resinous articles of this group are extensively 
employed in diseases of the urino-genital mucous membranes — 
gonorrhoea, gleet, leucorrhcea, incontinence of urine and cystitis. 

The following are the articles chiefly resorted to for their 
influence on the mucous membranes : — 

SENEGA. 

Polygala Senega, or Senega Snakeroot {Nat. Ord. Polygalaceae), 
is a small indigenous plant, found in all parts of the United States, 
but most abundantly in the South and West. It has a perennial 
branching root, several erect annual stems about a foot in height, 
alternate lanceolate leaves, and small whitish flowers arranged in 
a terminal spike. The root is the officinal portion. It occurs in 



BLENNORRHETICS SENEGA. 



379 



the shops in twisted pieces, varying in thickness from the size of 
a pill to that of the little finger, attached to a knotty head, and 
marked with a ridge along their whole length and numerous 
annular protuberances. The cortical portion is hard, resinous, of 
a yellowish-brown color, and contains the active qualities of the root. 
The central ligneous portion is white and inert. The odor of 
senega is peculiar and disagreeable, but faint in the dried root ; 
the taste is at first mucilaginous and sweetish, but afterward 
becomes acrid and very irritating. 



Fig. 37. 




POLYGALA SENEGA. 



The virtues of senega are extracted by cold and hot water and 
alcohol. It contains polygalic acid (senegin), on which its activity 
chiefly depends ; this is identical with saponin, a glucoside found 
in soapwort and other plants (Huseman*). 

Effects and Uses. — Senega, in small doses, is an active excitant 
of the mucous membranes and secretions generally, and in large 
doses proves emetic and cathartic. It is prescribed chiefly as a 
stimulating expectorant in chronic and subacute bronchial affec- 



Die Pflanzenstoffe," 1 871, p. 750. 



380 MATERIA MEDICA ECCRITICS. 

tions, and in the latter stages of acute bronchitis and pneumonia. 
As an ingredient in the compound syrup of squill it is much em- 
ployed in the treatment of croup, but, except in some such com- 
bination with tartar emetic or other emetic nauseant, it is scarcely 
admissible in the early stages of this disease. Senega is thought 
also to possess emmenagogue properties, and is highly extolled 
by many practitioners in the treatment of amenorrhcea. It has 
been occasionally used as a diuretic in dropsies, and in emeto- 
cathartic doses has been found useful in rheumatism. 

Administration. — Dose, in powder, gr. x-xx ; but the abstract 
is to be preferred ; dose, gr. v-xx. The fluid extract is given in 
the dose of ^x-xx; and syrup is also used, in the dose of f5j-ij- 

QUILLAIA. 

Quillaia, or Soap-bark, is the bark of the Quillaia Saponaria 
{Nat. Ord. Rosaceae), a tree of South America. The bark is 
found in the shops in large flat pieces, brownish-white, with 
small patches of brownish cork on the outer surface, but other- 
wise smooth ; without smell, but having a very acrid taste ; the 
powder is sternutatory (Maisch). It contains saponin (C 13 H 30 O 10 , 
a glucoside), which in watery infusion foams like soap, and is 
identical with polygalic acid (senegin). 

The following statement concerning saponin is based on the 
investigations of Lhomme * and Kobert \. According to the 
latter observer, saponin consists of at least four organic sub- 
stances, viz., of pure saponin (C 13 H 30 Oio, inert), lactosin (inert), 
quillaiac acid and sapotoxin — the last two, powerfully poisonous. 
The principle experimentally used by Lhomme seems to have 
been a mixture of these substances. Locally, it is a protoplasmic 
poison, and applied to the skin with friction is irritant, and if it 
be continued, will cause suppuration. It abolishes instantly the 
excitability of the striated muscles and nerves when in contact 
with them. Applied directly to the heart it rapidly stops it in 
diastole, and antagonizes the effect of digitalis upon it. Kobert 
ascertained, and his experiments were made with quillaiac acid, 
that when injected into the veins of dogs, and also by the 

* Pamphlet, " Etude exper. sur Taction physiol. de la saponine." 
"j: Arch.f. exper. Pathol, u. Pharmak., 1 887. 



BLENNORRHETICS GARLIC. 38 I 

stomach, it expended much of its force upon the alimentary 
canal, which was found to be in a highly inflamed condition. , 
Both he and Lhomme found that when introduced into the veins 
in sufficient quantity it paralyzed voluntary motion, abolished the 
reflex excitability of the cord, lowered the blood-pressure, and 
gradually stopped the heart's beats. Lhomme observed, without 
making exact experiments, that the urinary and dermal secretions 
were considerably diminished in frogs, rabbits and rats. Schroff 
noticed an increase of the bronchial mucus. 

Quillaia is rarely employed medicinally, nor are its exact thera- 
peutical uses yet placed on a scientific basis. As an expectorant 
in chronic bronchitis, emphysema and dilatation of the bronchi, it 
has recently been highly recommended (Kobert *). It is contra- 
indicated where a disposition to hemoptysis is present (A. Mas- 
lovskif), and in inflammatory conditions of the alimentary tract. 
It is chiefly useful from the property which it possesses of emul- 
sifying oils. A fluid extract mixed with glycerin forms an 
admirable local application to some cases of acne (Piffard). 
Dose, gr. xv-xxx in infusion t. d. 

ALLIUM GARLIC. 

Allium sativum {Nat. Ord. Liliaceae) is a small perennial, 
bulbous plant, which grows wild in the south of Europe, and 
is cultivated in all parts of the world. The bulb is the portion 
used. As found in the shops, it is somewhat spherical in form, 
about an inch in diameter, with the portion of the stem attached, 
covered with a white, membranous envelope, and consists of five 
or six smaller bulbs, of a curved, oblong shape, called cloves of 
garlic. They have a strong, irritating, characteristic odor and a 
bitter, acrid taste. Water, alcohol and vinegar extract their 
virtues, which depend on an essential oil, which is of a yellow 
color, very volatile and irritating; it consists of allyl (C 3 H 5 ) 
oxide and sulphide. 

Effects and Uses. — Garlic is a local irritant and rubefacient, and, 
taken internally, quickens the circulation and stimulates the secre- 
tions generally. It is a good deal employed as an expectorant 

* Central./. Klin. Med., No. 30, 1885. 
f Russ. Meditz., No. 36, 1886, p. 599. 



382 MATERIA MEDICA ECCRITICS. 

in chronic and subacute bronchial catarrh, particularly in infan- 
tile cases, and occasionally as a stomachic in flatulence, and as a 
diuretic in dropsies. Externally it is used as a revulsive rube- 
facient to the feet, as a resolvent of indolent tumors, and as a 
liniment in infantile convulsions. 

Administration. — A clove may be swallowed entire, or cut 
into small pieces. Dose of the fresh bulbs, 5j-ij, in pill; of the 
juice, f5ss, mixed with sugar; of the syrup, f5j, for children. 

SCILLA' — SQUILL. 

Squill, already noticed among Diuretics, is one of the most 
powerful and valuable stimulating expectorants in the Materia 
Medica. (For properties, doses, preparations, etc., see p. 367.) 

TEREBINTHINA — TURPENTINE. 

The term turpentine is applied to liquid or concrete vegetable 
juices, consisting of resin combined with a peculiar essential 
oil, called oil of turpentine. Two kinds of turpentine are recog- 
nized by the U. S. Pharmacopoeia : 1. The common American 
white turpentine, which is procured chiefly from. Pinus australis 
(Nat. Ord. Coniferae), a large indigenous evergreen tree of our 
southern States, where it is called Long-leaved Pine, Yellow Pine, 
and Pitch Pine ; and in part also from Pinus tasda, found in 
Virginia, and other species of Pinus. 2. Canada turpentine (Tere- 
binthina canadensis), kept in the shops under the name of Canada 
balsam or balsam of fir, the product of Abies balsamea, the Amer- 
ican Silver Fir or Balm of Gilead Tree (Nat. Ord. Coniferae), a 
handsome tree about forty feet in height, inhabiting the northern 
portions of North America. Many other varieties of turpentine 
are known in commerce, as Bordeaux turpentine, Venice turpentine, 
CJiian turpenti?ie, etc. 

White turpentine comes from North Carolina and other south- 
ern States, and is collected from excavations (called technically 
" boxes "*) made in the trunks of the trees, from March to Novem- 
ber, into which the turpentine runs in the mild weather. It is 
yellowish-white and somewhat translucent, semi-fluid in summer, 
firm and hard in winter, but becoming permanently hard by 

* " Our Slave States," 1856, p. 339, F. L. Olmsted. 



BLENNORRHETICS TURPENTINE 383 

exposure to the air, and has a peculiar aromatic odor and a 
warm, pungent, bitterish taste. Canada turpentine comes from , 
Canada and Maine. It is procured by breaking the vesicles 
which are found between the bark and wood of the trees and 
collecting the liquid contents in a bottle. When fresh it has the 
consistence of honey, but gradually solidifies by age. It is 
yellow, transparent, tenacious, of a peculiar pleasant, terebin- 
thinate odor and a slightly bitter, acrid taste. 

Chemical Constituents. — The turpentines yield, by distillation, 
a volatile oil, known as oil of turpentine, and leave a residue con- 
sisting exclusively of resin. Both the oil and resin are officinal. 
The turpentines are inflammable, nearly insoluble in water, but 
almost wholly soluble in alcohol and ether. 

Physiological Effects. — The local operation of the terebinthi- 
nates is irritant. When applied to the skin they produce a rube- 
facient effect, and when swallowed in large doses, promote the 
peristaltic motion of the intestines. Taken internally, in small 
doses, they are absorbed, and prove excitant to the vascular 
system and the secretions generally, especially the mucous mem- 
branes ; they communicate an odor of violets to the urine. In 
large doses they cause pain in the loins, strangury and bloody 
urine. The activity of the terebinthinates depends on their vola- 
tile oil. 

Medicinal Uses. — Turpentine is employed chiefly in diseases of 
the various mucous membranes, as gonorrhoea, gleet, leucorrhoea 
cystorrhcea, chronic bronchitis, and chronic mucous diarrhoea. 
It is also used in rheumatic complaints, and in iritis and sclero- 
titis ; and, in cathartic doses, in cases of ascarides, constipation, 
and colic. 

Administration. — Dose, as a blennorrhetic , gr. xx-5j, in ////, 
emidsioji, or electuary ; as an anthelmintic or cathartic, Sss-j in 
emulsion. The white turpentine is generally used in this country. 
Chian Turpentine is derived from Pistacia Terebinthus {Nat. 
Ord. Anacardiacese), and is collected chiefly in the island of Scio, 
during the summer months, the juice flowing spontaneously from 
incisions made in the bark. It is " greenish-yellow or brownish, 
hardens to a transparent mass, and has a fennel-like terebinthi- 
nate odor, and a mild, bitterish taste " (Maisch). It is very 
expensive, and but little of it comes to this country. It has been 



384 MATERIA MEDICA ECCRITICS. 

extolled in the treatment of uterine cancer, but sound observers* 
now agree that it is utterly valueless as a curative agent. Dose, 
gr. v, increased to gr. xxv, in emulsion. 

Oleum Terebinthin^e {Oil of Turpentine) (C 10 H 16 ), commonly 
called spirit of turpentine, is the active principle of turpentine, 
obtained by distillation. It is a limpid, colorless, volatile and 
inflammable liquid, of a strong, penetrating, peculiar odor and a 
hot, pungent, bitterish taste ; very slightly soluble in water, less 
soluble in alcohol than the volatile oils generally, and wholly 
soluble in ether ; exposed to the air it absorbs oxygen, with the 
formation of resin. Its effects and medicinal uses are the same 
as those of turpentine, for which it is usually substituted in 
practice. Locally, it acts as a rubefacient. When sivallowed in 
large doses, as f 5J-ij, it commonly passes off by the bowels ; 
taken in small doses, it is absorbed and, according to the recent 
investigations of Hare,f it increases the number of the cardiac 
beats, due to direct action on the heart; large doses decidedly 
slow the pulse by stimulation of the vagus inhibitory centre. Its 
influence, either in large or small amounts, is indifferent upon the 
vaso-motor centre, though this statement, is not in accord with 
that of Kobert.J Small doses increase reflex action, while large 
decrease it; the first being due to stimulation, and the latter 
to depression of the cord and afferent nerves. Toxic amounts 
destroy life by causing cardiac failure. Respiration is at first 
increased, but afterward diminished as to frequency. Secretion : 
when given in moderate doses it stimulates the kidneys, increas- 
ing the urinary flow. In large amounts (fSj-ij), the urine is 
diminished, often bloody and sometimes suppressed. Toxic 
quantities provoke constant efforts at micturition, strangury, and 
often priapism. Gastro-intestinal tract : in large quantities it 
causes vomiting and purging, with abdominal pain and a sense 
of heat. Elimination : by the broncho-pulmonary mucous mem- 
brane and kidneys (chiefly). 

The lethal dose is not determined, but poisonous effects from the 
oil of turpentine are rare, as it generally passes off by the bowels ; 



* Lancet, Dec. 4th, 1880. Mr. Henry Morris. 

f Med. News, Phila , 18S7, II, p. 593. 

% Arch, fur Anat. u. Physiol., 1886 — quoted. 



BLENNORRHETICS TURPENTINE. 385 

it may, however, produce severe vomiting and purging, bloody 
or suppressed urine, intense irritation of the urino-genital organs., 
unconsciousness, with dilated pupils, and even death. • (An in- 
fant* swallowed f&}4, and recovered after convulsions.) 

Oil of turpentine is contra-indicated in cardiac hypertrophy, 
atheroma of the vessels, and acute inflammatory diseases of the 
kidneys. It is incompatible with cardiac depressants. Its action 
is aided by the alcoholic and diffusible stimuli. 

In large doses it is employed as an anthelmintic and cathartic, 
and is much used as a clyster for the relief of tympanites. In 
small doses it is much prescribed in chronic discharges and 
hemorrhages from the various mucous membranes ; in the latter 
stages of typhoid fever, where the abdomen is tympanitic and the 
tongue dry ; as a combined stimulant and blennorrhetic ; as a 
stimulant in typhus feverf ; as a diaphoretic in rheumatism, in 
infantile diabetes and nephritic disorders. As a rubefacient, it is 
a valuable counter-irritant in numerous diseases, as to the joints 
in chronic rheumatism, and should often be applied with gentle 
friction. Turpentine stupes are highly efficacious in bronchial 
catarrhal affections. Dose, gtt. v-xxx, repeated, as a blennorrhetic 
stimulant ; f oSS— j, as a cathartic enema or anthelmintic X in emulsion 
or capsule. Linimentum terebinthincs (oil of turpentine, 35 parts, 
melted with resin-cerate, 65 parts), is used as an application to 
burns and scalds. 

Pix LiQUiDA(7dr) is an impure turpentine, procured, by burn- 
ing, from the wood of Pinus palustris and other species of Pinus. 
It is a brownish-black, viscid, semi-liquid substance, of a peculiar 
empyreumatic odor and a bitterish, resinous, somewhat acid 
taste ; soluble in alcohol, ether and the volatile and fixed oils. 
It consists of resin united with acetic acid, oil of turpentine and 
various volatile empyreumatic products. By distillation it yields 
pyroligneous acid and oil of tar, the residuum being pitch. 

The oil of tar (oleum picis liquidce) contains, besides oil of tur- 
pentine, creasote (see Antiseptics) and other principles. Its effects 
are similar to those of tar, and it is much used in the form of 



* London Med. Times, 1 85 1, p. 380. 
f Am. fourn. Med. Sci., 1866, p. 48. DaCosta. 
J Journal de Therap., 1876, p. 871. 
25 



386 MATERIA MEDICA ECCRITICS. 

ointment in the treatment of squamous diseases. A case is re- 
ported, of non-fatal poisoning,* by oil of tar, of a man who, 
having swallowed about one gill, was seized after seven hours 
with vomiting, excessive abdominal and inguinal pain and ex- 
haustion, the urine being high-colored and having the odor of the 
drug. 

Effects and Uses. — Tar resembles the turpentines in its effects, 
and is employed in chronic catarrhal affections and other diseases 
of the mucous membranes. Its vapor has been employed in 
bronchitis ; and externally it is an excellent application in tinea 
capitis, psoriasis and eczema. The therapeutical application of 
the tarry preparations in diseases of the skin has been well 
described by Bulkley f as follows : they are contra-indicated in 
cases of decided pain, heat or swelling, and indicated where it is 
desirable to improve the nutrition, check the itching, secretion and 
cell deposit of a part. Their disadvantages are odor, color and 
stickiness : the former can be partly disguised by oil of lavender. 
Equal parts of pix liquida and unguentum sulphuris is an excel- 
lent application to scaly eczema and palmar psoriasis, and it 
should be applied with friction. In liquid form the following 
has been used with advantage to allay the intense itching of 
eczema after the exudation has ceased. Jfy Picis liquidae, f 5ij ; 
potassae causticae, 5 j ; aquae, 5 v. M. Solve (may require dilution); 
in chronic cases should be rubbed in of full strength. In para- 
sitic diseases the following unirritating combination is useful : 
3^ Iodinii, 5ij ; olei picis liquidae, f Sj. M. Solve. Mix care- 
fully, and rub in freely. Dose, 5ss-j several times a day, in pill 
or electuary. 

The syrup contains six per cent, of tar, and is a good prepara- 
tion. The ointment {unguentum picis liquidce) is made by mixing 
equal parts of tar and melted suet. 

Resina {Resin), commonly called rosin, is the residue after the 
distillation of the oil from turpentine. It is a yellowish-brown^ 
semi-transparent, solid, brittle substance, with a slight terebin- 
thinate odor and taste — insoluble in water, soluble in ether, alco- 
hol and the essential oils, readily uniting by fusion with wax and 



* Lancet, 1 832-3, p. 598. 

f Arch, of Scientific and Practical Medicine, 1873, pp. 123, 172. 



BLENNORRHETICS COPAIBA. 387 

the fixed oils, and forming soluble soaps with alkalies. When 
agitated with water, in a state of fusion it becomes opaque and 
white. It is not used internally, but is extensively employed in 
the formation of plasters and ointments, to which it communicates 
great adhesiveness and slightly stimulant properties. 

Ceratum re since (resin-cerate), formerly called basilicon ointment, 
is made by melting resin (35 parts), lard (50 parts) and yellow 
wax (15 parts) together; it is an excellent mild stimulant applica- 
tion to burns, blistered surfaces, etc. Compound resin-cerate 
may be made by melting Sxij of resin, suet and yellow wax, each, 
with 5yj of turpentine and fgvij of flaxseed oil — a good stimulant 
cerate, very popular under the name of Deshler's Salve. Emplas- 
trum resince (resin-plaster), made by melting 14 parts of resin with 
80 parts of lead-plaster and 6 parts of yellow wax, is the well- 
known adhesive plaster, used to retain the edges of wounds in 
contact, to produce extension in the treatment of fractures, to 
protect excoriated surfaces, and to promote absorption. 

COPAIBA. 

Copaiba is an oleo-resin obtained from several species of 
Copaifera (Nat. Ord. Leguminosae), large trees peculiar to South 
America. C. Langsdorffii, a native of Brazil, is now recognized 
as the principal source of copaiba, and most of the copaiba of 
commerce is derived* from the ports of Para and Maranham, in 
Brazil ; Central America also yields copaiba. The juice is 
obtained from incisions in the stems of the trees ; as it at first 
exudes it is clear, colorless and very thin, but soon acquires a 
thicker consistence and a yellowish hue. As found in the shops 
it is a clear, transparent liquid, of the consistence of olive-oil, of 
a pale-yellow color, a peculiar agreeable smell and a pungent, 
nauseous, acrid taste. By exposure to the air it acquires a deeper 
color and denser consistency. It is often adulterated. 

Copaiba is insoluble in water, but soluble in alcohol, ether, and 
the volatile and fixed oils ; with alkalies and alkaline earths it 
forms a soap. It is chemically an oleo-resin (40 to 60 per cent, of 
volatile oil, but the proportion of oil to resin varies considerablyf ), 
with a minute portion of acetic acid. The volatile oil is offi- 

* " Pharmacographia," 2d ed.,p. 232. f Am. Journ. of Syphilography, III, p. 293. 



388 MATERIA MEDICA ECCRITICS. 

cinal, as is also the resin, which possesses acid properties, and is 
sometimes called copaivic acid. By exposure to the air copaiba 
gradually becomes darker and thicker, and finally hard and brittle, 
owing to the volatilization and oxidation of its oil. Copaiba was 
formerly called a balsam, but this title is incorrect, as it contains 
no benzoic or cinnamic acid. 

Effects and Uses. — The effects of copaiba are analogous to those 
of the terebinthinates. In large doses it proves cathartic and 
occasionally emetic, and in small doses it is absorbed, communi- 
cating its peculiar odor to the secretions and exhalations, and 
stimulating the secretions from the mucous membranes and kid- 
neys ; it is also a gentle excitant to the circulatory system. The 
urine of persons who have taken copaiba for some time yields a 
precipitate with nitric acid, like albuminous ' urine, due to the 
action of the acid on the resin. The resinous precipitate, how- 
ever, is soluble in alcohol, which does not dissolve coagulated 
albumen. Elimination takes place slowly. Occasionally copaiba 
causes symptoms of strangury when given in large doses. It 
sometimes produces an eruption of the skin, and some persons 
are unable to take it in any dose, on account of the gastro-intes- 
tinal irritation which it occasions. When its administration is too 
long continued, or when excessive doses are given, it may un- 
doubtedly cause serious damage to the structure of the kidney. 
Copaiba is employed in diseases of the mucous membranes, par- 
ticularly those of a chronic character, as chronic bronchitis, 
chronic diarrhoea, leucorrhcea, gonorrhoea, gleet, catarrh, and 
irritation of the bladder, and, like turpentine, occasionally in rheu- 
matism and iritis. 

As a remedy in gonorrhoea it has long enjoyed great popu- 
larity, and is given with advantage even in the earliest stages. 
Though often of signal service in the treatment of gonorrhoea, 
yet it frequently fails to ameliorate the disease, for, in 15 cases in 
which copaiba was the basis of treatment together with injections, 
recorded by Milton,* the average duration of each was 88 days — 
not brilliant evidence of the utility of the remedy. The good 
results obtainable with this drug are often missed through inat- 
tention to concomitant matters. During the acute stage the 

* " Gonorrhoea," etc., 1877, p. 75. 



BLENNORRHETICS CUBEB. 389 

inflammatory symptoms must be combated by rest, the local 
application of lead- or ice-water, the parts kept clean, the urine 
neutralized, a non-stimulant diet enforced, and above all, erections 
should be suppressed, as by avoiding lascivious thoughts, and 
chordee restrained by giving a large dose of potassium bromide 
(5/4— j), at 9-10 p.m., combined with a motor-depressant, as tincture 
of gelsemium (gtt. x), both to be repeated at 3-4 a.m., the time 
when chordee is most likely to begin. Chordee can also be 
checked by the application of a glass or rubber bottle filled with 
cold water to the perineum. Urethral injections of copaiba have 
been tried, but have not yielded good results ; it therefore appears 
to be necessary, in order to obtain its curative effects, that the 
drug should be modified in the system before its passage over the 
urethral tract. In gonorrhceal vulvitis and vaginitis it is com- 
paratively useless. Copaiba is sometimes advantageously com- 
bined or alternated with cubeb. When it nauseates, it should be 
suspended, or the dose reduced. It is best administered on an 
empty stomach. It is often advantageously combined with solu- 
tion of potassa, which diminishes the acidity of, and hence the 
irritation produced by, the urine. 

Administration. — Dose, gtt. xx to f 5j t. d., in emulsion, with 
some aromatic water,* or in pilular mass (massa copaiba), made 
by mixing copaiba 94 parts with magnesia 6 parts, or in capsules 
of gelatin, which is the preferable mode of administration. These 
can be obtained in the shops, each containing n^v or x. It is 
also administered as a clyster, in emulsion. 

Oleum Copaib^e {Oil of Copaiba) (Q5H24), obtained by distilla- 
tion from copaiba, is usually colorless, with the odor and taste of 
copaiba, and produces the same effects on the system. (U. S. 
Dispensatory, 15th Ed.) Dose, gtt. x-xv, in emulsion or dropped 
on sugar. 

CUBEBA CUBEB. 

Cubeb is the unripe fruit of Cubeba officinalis (Nat. Ord. 
Piperacese), a climbing perennial plant of Java and other parts of 
the East Indies. The berries are gathered for use when unripe, 

* Chapman's Copaiba Mixture is, copaiba and spirit of nitrous ether, each half a 
fluidounce ; powdered gum-arabic and sugar, each a drachm ; compound spirit of lav- 
ender, 2 fluidrachms; tincture of opium, a fiuidrachm; distilled water, 4 fluidounces; 
dose, a tablespoonful three times a day. 



390 MATERIA MEDICA ECCRITICS. 

and are dried. They are about the size of a small pea, of a 
blackish or grayish-brown color, a reticulated surface, and fur- 
nished with a stalk two or three lines long. The shell is hard, 
and contains a blackish seed, which is white and oily within. The 
odor of cubeb is aromatic ; the taste warm, acrid, and camphor- 
aceous. The berries deteriorate by age, most rapidly in powder, 
owing to the escape of their volatile oil. Their most interesting 
constituents are a volatile oil (which is officinal) (C 30 H 48 ), a 
principle called cubebin, and resinous matter ; the resinous matter 
consists of both a hard and a soft resin, the former insoluble in 
ether, the latter soluble in ether, of acid reaction, and termed 
cubebic acid. The oil is carminative and stimulant, and the 
blennorrhetic and diuretic properties of cubeb reside chiefly in 
the resin ; cubebin is inert. 

Effects and Uses. — In large doses cubeb, like the other oleo- 
resins, excites more or less gastro-enteric disturbance. In small 
doses it produces a stomachic effect like that of black pepper; 
after its absorption it acts as a gentle excitant to the vascular 
system, with a very" decided stimulant action on the mucous sur- 
faces, particularly those of the urino-genital apparatus ; it also 
frequently proves diuretic. It is eliminated chiefly by the urine, 
increasing the excretion of uric acid, and under its use the urine 
yields a precipitate with nitric acid. An eruption, like urticaria, 
sometimes follows the administration of both copaiba and cubeb. 

It is used chiefly in the treatment of gonorrhoea, and should be 
given in the early stage of the disease, under the same conditions 
as copaiba (q. v.). The late Prof. Joseph Pancoast prescribed it 
as follows : 1^ Pulveris alumenis, 5j ; pulveris cubebae, Siv ; pul- 
veris cinnamomi, Sss. M. et Sig. — Tablespoon in half glass of 
water, three times a day. When thus given, it quickly allays the 
scalding pain which accompanies urination. In other mucous 
discharges, as chronic catarrh with profuse secretion, leucor- 
rhcea, gleet, and cystitis, cubeb has been also employed with 
advantage. 

Administration. — Dose of the powder, 5j-hj t. d., in gonorrhoea; 
in chronic mucous disorders smaller doses are given. The oil 
is often employed, but it does not possess the full virtues of cubeb — 
dose, gtt. x-xij, to be repeated and gradually increased; it may 
be taken in emulsion, or dropped on sugar, or made into gelatin- 



BLENNORRHETICS OIL OF SANTAL. 39 1 

ous capsules with oil of copaiba. The oleo-resin contains both the 
volatile oil and resin, with a portion of cubebin, and is an excel- 
lent preparation — dose, ^v-xxx, suspended in water; of the 
tincture, the dose is f5j-ij t. d. : of the fluid extract, the dose is 
f5ss-j. Troches of cube b are made with the oleo-resin, oil of sas- 
safras, extract of glycyrrhiza, and acacia, mixed with syrup of 
tolu. Each troche contains gr. ^ of oleo-resin. 

OLEUM SANTALI OIL OF SANTAL. 

The oil of Santal or of Sandal Wood is a volatile oil distilled 
from the wood of Santal urn album [Nat. Ord. Santalaceae), a small 
tree found in tropical Asia. 

The oil is pale yellowish and thick, readily soluble in alcohol 
when fresh, having an aromatic odor resembling the smell of the 
wood, and a pungent, spicy taste. 

It has been highly recommended in the treatment of gonorrhoea, 
having been introduced by Henderson* who states that he always 
obtained with it marked suppression of the discharge, and by 
whom it is regarded as quite equal to copaiba. Beach f reports 
his experience in ioo cases as follows: average duration of the 
uncomplicated cases six weeks, shortest case six days, longest 
about 42 days, which is good evidence of its efficacy. He gave 
gtt. xx or more t. d. In this disease its effects seem to be similar 
to those of copaiba, but it is not so apt to disagree with the stom- 
ach. In a series of 12 cases of gonorrhoea in which it was admin- 
istered in doses of gtt. x, t. d., the results were not uniform. In 
a few cases it appeared to cut short the disease in about four 
days ; in others it disagreed with the patient and was abandoned, 
and in some cases no benefit was obtained (C. B.). MiltonJ records 
22 cases without a single cure. It occasionally (in about four per 
cent, of cases) produces vertigo, when the dose should be lessened 
or the medicine discontinued. It is very expensive, and is often 
adulterated with olive-oil. It may be given in doses of ^v-xx, 
t. d. on a lump of sugar, in mucilage, in alcohol and cinnamon 
water, or it can be obtained in gelatin capsules, ^v each, in the 



* Glasgow Med. Journ., Vol. xm, p. 70; and Med. Times and Gaz., 1865, p. 571. 
f Boston Med. and Surg. Journ., 1868-9, P- 2I 3* 
% " Gonorrhoea etc.," 1887^.87. 



392 MATERIA MEDICA ECCRITICS. 

shops. An objection to its use is the odor of the drug, which its 
ingestion soon imparts to the breath. It should be administered 
at the onset of the disease. 

MATICO. 

This name is given to the leaves of Artanthe elongata (A T at. 
Ord. Piperacese), a shrub of Peru. They are from two to six 
inches long by about an inch in breadth, oval-lanceolate and 
acuminate in shape, crenate, strongly veined or reticulated, 
bright-green on the upper surface, paler beneath, of a pleasant, 
aromatic odor and a strong, spicy, slightly astringent taste. The 
stalks and spikes of the plant are generally mixed with the leaves, 
more or less compressed into a lump of a greenish color. Matico 
contains resin, volatile oil, artanthic acid, tannin, etc. 

Effects and Uses. — Matico is a pleasant, aromatic tonic, with a 
special determination to the mucous membranes. It is used as 
an alterative stimulant in the entire circle of diseased mucous 
membranes, especially those of the urinary passages. It is also 
used internally as a hemostatic, and locally as a styptic. Dose, 
of the powder, 5ss-j ; of Xheflirid extract, f 5ss-j ; of the tincture, 
f5j-ij. 

PAREIRA. 

Pareira or Pareira Brava is the root of Chondodendron 
tomentosum (Nat. Ord. Menispermaceae), a native of Brazil. It 
comes to us in large, wrinkled, twisted or forked cylindrical 
pieces, of variable thickness and length, covered with a thin, 
grayish-brown bark. The interior is ligneous, yellowish, porous, 
inodorous, and of sweetish, nauseous, bitter taste. It imparts its 
virtues to water, and contains a bitter alkaloid, termed cissam- 
pcline (C 18 H 21 N0 3 ), (identical with pelosine, luxine and beberine, 
Fliickiger,*) resin, fecida, etc. The stem is sometimes found in 
the shops mixed with the root ; it is inert. 

Effects and Uses. — Pareira is an excellent remedy in chronic 
diseases of the urinary passages, particularly chronic inflamma- 
tion or irritation of the bladder, with morbid secretion. It is 
thought to be also tonic, aperient, and diuretic. Dose, in sub- 
stance, 3ss-j. The fluid extract is much used — dose, f5ss-j.f 

* " Pharmacographia," 2d edition, pp. 28 and 109. 

f A good prescription in irritable bladder is fluid extract pareira brava, f ^j ; com- 
pound spirit of juniper, f ^ ij ; benzoic acid, 3 j ; sulphate of morphine, gr. j ; dose, a 
teaspoonful three times a day. 



BLENNORRHETICS UVA URSI. 393 

BUCHU. 

This is the name given to the leaves of Barosma betulina and' 
other species of Barosma {Nat. Ord. Rutacese), shrubby plants, 
growing "at the Cape of Good Hope. As found in the shops, 
buchu leaves are from three-quarters of an inch to an inch and a 
half long, from three to five lines broad, elliptical, lanceolate- 
ovate or obovate, sometimes pointed, sometimes blunt, notched, 
and glandular at the edges, and of a green color, paler on the 
under surface. Three varieties are known, viz. : short or round 
buchu (derived from B. betulina), medium-sized (from B. crenu- 
lata), and long buchu (from B. serratifolia). They have a strong, 
aromatic odor and a bitterish taste, like that of mint. Water and 
alcohol extract their virtues, which depend on a volatile oil (which 
yields barosma camphor *) and bitter extractive. 

Effects and Uses. — Buchu is a gentle stimulant to the secre- 
tions generally, particularly to the kidneys and urinary mucous 
membranes ; it may be made to act also as a diaphoretic. It is 
employed in chronic catarrh of the urethra and bladder, chronic 
nephritic complaints, retention or incontinence of urine ; as a 
diuretic in dropsies, and as a diaphoretic in rheumatic and cuta- 
neous complaints. Dose, of the powder, gr. xx-xxx ; of the 
fluid extract, f 5ss— j. 

UVA URSI. 

Arctostaphylos Uva ursi, or Bearberry {Nat. Ord. Ericaceae), 
is a small trailing evergreen shrub, with coriaceous, obovate 
leaves (somewhat like the box leaves and red-whortleberry 
leaves), about half an inch in length, pale rose-colored flowers 
appearing from June to September, and small red berries which 
ripen during the winter. It is found in the northern parts of 
Asia, Europe and America. The leaves are the only part used. 
When dried they have a faint hay-like odor and a bitterish, 
astringent taste. They yield their virtues to water and alcohol, 
and contain tannic and gallic acids, ursone, a crystallizable gluco- 
side termed arbutin (C^H^O^), a bitter substance termed ericolin 
(C 34 H 56 21 ), extractive, resin, gum, etc. 

Effects a?td Uses. — Uva ursi is astringent, tonic, and diuretic, 

* " Pharmacographia," 2d edition, pp. 28 and 109. 



394 



MATERIA MEDICA ECCRITICS, 



and exercises a beneficent control over discharges from mucous 
surfaces ; hence its employment in catarrh of the bladder, 
chronic bronchitis with profuse discharge, etc. It is applicable 



Fig. 38. 




also to the ordinary uses of the vegetable astringents. Dose, of 
the powder, gr. x-5j. The dose of the fluid extract is f5ss-j. 



CH1MAPHILA. 

Chimaphila umbellata, Pipsissewa, Wintergreen, or Ground- 
Holly (Nat. Ord. Ericaceae), is a small indigenous evergreen 
plant, common to the northern parts of Europe, Asia and 
America, and found abundantly in woody situations in all parts 
of the United States. It has an erect stem three to ten inches 
high, lanceolate, somewhat wedge-shaped, serrated, dark-green 
leaves arranged in irregular whorls, and beautiful five-petaled 
flowers, of a white color tinged with red and a very agreeable 
perfume, which appear in June. The leaves are the officinal 
portion. In the fresh state they have a fragrant smell when 
bruised, which they lose after drying. Their taste is bitterish 
and astringent, but somewhat aromatic. They contain arbutin, 
tannic acid, chimaphilin, etc. Chimaphila maculata, or Spotted 



BLENNORRHETICS CHIMAPHILA. 



395 



Pipsissewa, possesses properties analogous to those of C. umbel- 
lata, from which it differs principally in the character of its leaves. 
They are of a deep olive-green color, mixed with greenish-white; 
and the flowers are of a pure white, and appear in July. 

Effects and Uses. — Pipsissewa is a tonic, astringent, diuretic and 

Fig. 39. 




CHIMAPHILA UMBELLATA. 



blejinorrhetic ; resembling buchu and uva ursi in its effects, but 
being a more active diuretic, and is used in the disorders of uri- 
nary organs to which they are applicable, and, from its diuretic 
properties, in dropsy, especially when attended with debility of 
the digestive organs. The dose of the fluid extract is f 5ss-j. 



396 MATERIA MEDICA ECCRITICS. 

MYRRH A MYRRH. 

Myrrh is a gum-resin obtained from Balsamodendron Myrrha 
{Nat. Ord. Burseraceae), a small shrubby tree of Arabia Felix 
and Africa. Most of the myrrh of commerce is derived from 
the eastern coast of Africa, in the Somali* district, where it is 
collected by the Arabs. The juice exudes spontaneously and 
concretes upon the bark (like cherry-tree gum). It is imported 
from Bombay, and occurs in small, semi-transparent, reddish- 
yellow fragments or tears — sometimes agglutinated together in 
large masses — of irregular shape and size, with an agreeable, 
peculiar odor and a bitter, aromatic taste. It is brittle and pulver- 
izable, has a resinous fracture, and makes a light-yellowish 
powder. Inferior kinds of myrrh are darker and less translucent 
and odorous. Myrrh is a gum-resin (of resin 25-40 per cent.), 
containing also a little volatile oil (^ per cent.) and a bitter 
principle (glucoside ?). It forms with water an emulsion, and is 
soluble in alcohol and ether. 

Effects and Uses. — Myrrh is a stimulant, . expectorant and 
emmenagogue. It is prescribed in chronic catarrhal and asth- 
matic affections in which a combined corroborant and expectorant 
effect is desirable. Chalybeates and aloes are frequently united 
with it in uterine affections. Locally, it is a good application to 
spongy gums and aphthous sore mouth. In fetid breath the fol- 
lowing is a good cleansing mouth-wash : ^ Tincturae myrrhae, 
f Sj ; acidi carbolici liquidi, ^x. M. Sig. — Teaspoonful in y 2 
tumbler of water as a mouth-wash. 

Administration. — Dose, gr. x-xxx in powder or pill, or sus- 
pended in water, as in mistura ferri composita (see p. 161). The 
tincture is employed chiefly externally ; dose, internally, f5ss-j. 
Pills of aloes and myrrh, compound g alb anum pills and compound 
iron-pills are officinal emmenagogue preparations of myrrh. 

BENZOINUM BENZOIN. 

Benzoin is a balsamic resin obtained from Styrax Benzoin, 
or Benjamin tree {Nat. Ord. Styraceae), a tall tree of northern 
Sumatra,f and Siam. It is obtained by incisions in the bark, 

* Pharm. Journal, XII, p. 226. Jas. Vaugh. 
-j- " History of Sumatra," p. 123, 1783, Marsden. 



BLENNORRHETICS STORAX. 397 

from which it readily exudes, afterward hardening by exposure 
to the sun and air, when it'is pared off with a knife. Two kind's 
are known, the more valuable consisting chiefly of whitish tears, 
united by a reddish-brown connecting medium, and called benzoe 
amygdaloides, the other of brown or blackish lumps, without tears, 
known as benzoe in sortis {benzoin in sorts). Benzoin has a fra- 
grant odor, a feeble, slightly aromatic taste, is soluble in alcohol 
and ether, and is precipitated from its alcoholic solution by water. 
Its chief constituents are resin and benzoic acid (C 7 H 6 2 ), which 
places it among the balsams ; it contains volatile oil and occasion- 
ally cinnamic acid (C 9 H 8 2 ). Samples containing the latter should 
be rejected (U. S. P.). 

Effects and Uses. — This drug owes its virtues chiefly to benzoic 
acid, which will be considered under the head of Antiseptics. 
Benzoin is a topical irritant, and after absorption, stimulates the 
broncho-pulmonary and other mucous membranes. It resembles 
myrrh in its effects, but is rather more acrid and stimulating. It 
is adapted to chronic bronchial affections, but is seldom employed 
alone. As a fumigation in chronic laryngitis it has been recom- 
mended by Trousseau and Pidoux. It is also used in chronic 
cystitis when the urine is alkaline and deposits phosphates, but 
the benzoates, especially ammonium benzoate, are more adapted 
to these cases. 

Dose, gr. x-xxx. The tincture of benzoin and the compound 
tincture (containing benzoin, purified aloes, storax and balsam 
of tolu dissolved in alcohol) are used as stimulating expecto- 
rants and in bowel complaints; dose, f5ss-ij. As benzoin has 
the property of obviating the rancidity to which lard is liable, 
this is a very useful vehicle for medicated ointments. Adeps 
benzoinatus consists of benzoin, 2 parts, and lard, ioo parts. 
Benzoin is much used in the form of fumigating pastiles. 

STYR AX STORAX . 

Storax is a balsam prepared from the bark of Liquidambar 
orientalis {Nat. Ord. Hamamelaceae), a native of Asia Minor. It 
is obtained by steaming the bruised bark and then expressing it, 
and occurs as a soft, viscid, brownish mass of the consistence of 
honey, yet more or less tenacious, of a fragrant odor and a warm 
taste. It contains storesin, an amorphous substance— the most 



39$ MATERIA MEDICA ECCRITICS. 

abundant constituent — an oil termed styrol (C 8 H 8 ) (not always 
present), resin, cinnamic acid (and is therefore a balsam), and an 
essential oil. Alcohol and ether are its proper solvents. It is 
almost always more or less adulterated. 

Effects and Uses. — It is used as a stimulant expectorant, chiefly 
in the compound tincture of benzoin ; dose, gr. x-xx. 

BALSAMUM PERUVIANUM BALSAM OF PERU. 

Balsam of Peru is a balsam obtained from Myroxylon Pereirae 
{Nat. Ord. Leguminosae), a tree of Central America (Salvador). 
It is obtained from incisions in the bark, and is collected on rags 
inserted in the openings, which are afterward boiled in water, 
when the balsam settles at the bottom, and the water is poured 
off. A white balsam, obtained from the fruit of this tree by 
expression, and a tincture of the fruit in rum, are also known in 
Central America. Balsam of Peru has the consistence of honey, 
a dark, reddish-brown color, a pleasant smell, a warm, bitterish, 
acrid taste, and is soluble in alcohol and partially so in boiling 
water. It is heavier than water. Its constituents are cinnamein 
(benzylic cinnamate, a colorless aromatic oil), resin, benzalcohol, 
benzylic benzoate, stilbene, and cinnamic and benzoic acids. 

Effects and Uses. — It is a stimulating blennorrhetic and tonic, 
employed occasionally in chronic catarrh, asthma, gonorrhoea, 
leucorrhcea, etc., but not much used in this country. Externally 
it is applied to indolent ulcers. Dose, f 5ss in emulsion. 

BALSAMUM TOLUTANUM BALSAM OF TOLU. 

Balsam of Tolu is a balsam obtained from Myroxylon toluifera 
{Nat. Ord. Leguminosae), a tree of the neighborhood of Cartha- 
gena. It is procured from incisions in the trunk of the tree, and 
concretes in the vessels in which it is received. It has a soft, 
tenacious consistence, varying with the temperature, and by age 
becomes hard and resin-like. It is shining, translucent, of a 
reddish-brown color, a fragrant odor and a warm, sweetish, pun- 
gent taste, inflammable, entirely soluble in alcohol and essential 
oils, and, like the other balsams, yields its acid to boiling water. 
Its ingredients are resins, benzylic benzoate (a colorless aromatic 
oil), benzylic cinnamate, tolene, and cinnamic and benzoic acids. 

Effects and Uses. — It is a stimulant blennorrhetic and tonic, 



EMMENAGOGUES. 399 

useful in chronic catarrhal affections, and, from its agreeable 
flavor, much employed as an ingredient of cough mixtures. The 
vapor of an ethereal solution of this balsam is inhaled with 
advantage for the relief of cough. Dose, gr. x-xxx, in emulsion, 
frequently repeated. The tincture (tinctura tolutanci) is added to 
cough mixtures; dose, f5j-ij. The syrup (syrupus tolutanus) is 
used as a vehicle for other medicines. Balsam of tolu is an 
ingredient of the compound tincture of benzoin. 

The following gum-resins, previously noticed among anti- 
spasmodics, are employed as expectorants : — 

Asafcetida (Asafetida). (Seep. 113.) 

Ammoniacum {Ammoniac). (Seep. 115.) 

Galbanum. (Seep. 115.) 



ORDER VI. EMMENAGOGUES. 

Emmenagogues (from ifj./j.ijvta, the catamenia, and aycayoq, excit- 
ing) are medicines which promote the menstrual discharge. This 
discharge may be suppressed from various causes, and hence 
very opposite classes of remedies are employed to restore it. 
Thus, when amenorrhcea depends on ancemia, the preparations 
of iron are the most effectual emmenagogues ; on the other 
hand, when it occurs in connection with plethora, blood-letting 
and evacuants are resorted to. There are probably no articles 
which exert any specific influence upon the catamenia, as the 
discharge from the uterus is not one of the excretions through 
which medicinal agents pass out of the system. Medicines, 
however, which excite the pelvic circulation and stimulate the 
organs in the neighborhood of the uterus have a tendency to 
increase or excite the menstrual discharge. They are — 
,1. The mild acrid cathartics, as Aloes (p. 337), etc. 

2. Many of the stimulating diuretics, particularly Cantharides 

(P- 377)- 

3. Some of the blennorrheas, particularly Senega (p. 378). 

4. Guaiacum (p. 362), usually classed with the diaphoretics. 
Indirectly, the menstrual discharge is frequently promoted by — 
I . The preparations of Iron and of Manganese (especially Potas- 
sium Permanganate), which are the best emmenagogues in chlo- 
rotic and anaemic cases. 



400 MATERIA MEDICA ECCRITICS. 

2. Mercurials, which prove emmenagogue from their influence 
in exciting the secretions generally. 

The following articles are employed exclusively as emmena- 
gogues : — 

SABINA — SAVINE. 

Savine is the tops of Juniperus Sabina (Nat. Ord. Coniferse), 
a small evergreen bushy shrub of the south of Europe. They 
resemble closely the tops of Juniperus virginiana, the indigenous 
Red Cedar, which are sometimes substituted for savine in the 
shops. The latter has a greenish color, a strong, peculiar, heavy 
odor and a bitter, nauseous, resinous taste. Its virtues depend 
on a volatile oil, which is officinal. 

Physiological Effects. — Savine is a local irritant. Taken inter- 
nally, in medicinal doses, it stimulates the circulation and secre- 
tions, with a very decided action on the uterus. In large doses 
it will cause vomiting, purging, abdominal pain, suppressed or 
bloody urine, with 'symptoms of nervous depression, as shown 
in unconsciousness, stertorous breathing, perhaps convulsions, 
and death, usually from collapse. Fatal* results have occurred 
in several cases from its use to provoke premature labor. 

Medicinal Uses. — Savine is employed internally almost exclu- 
sively as an emmenagogue, and is considered one of the best 
medicines that can be used to stimulate the action of the uterine 
vessels, and its physiological action is intensified by combination 
with oil of rue. Pereira f pronounces it " the most certain and 
powerful emmenagogue of the whole Materia Medica." It has 
been successfully used in menorrhagia depending on relaxation 
of the uterine tissues. It has been also recommended in chronic 
rheumatism, and as an anthelmintic. Topically, it is used to keep 
up the discharge from blisters, to destroy warts, etc. Dose, in 
powder, gr. v-x; but it loses much of its oil by drying; of the 
fluid extract the dose is ttjjv— x. Ceratum sabince (fluid extract, 
25 parts, resin cerate, gp parts) is used to make perpetual blisters. 

Oleum Sabince (Oil of Savine) (C 10 H 16 ) is the preparation 
principally used internally. Dose, gtt. v-x — in capsules, pill or 
emulsion. 

* " A Treatise on Poisons," 4th ed., p. 605. Christison. 
f " Mat. Med. and Therap.," 4th ed., p. 332. 



EMMENAGOGUES TANSY. 401 

Oleum Rutve {Oil of Rue) is a volatile oil distilled from Ruta 
graveolens (Nat. Ord. Rutacese), a perennial European plarrt, 
with tripinnate leaves, obovate leaflets and yellow flowers. The 
oil is a colorless or greenish-yellow liquid, of a characteristic, 
aromatic odor, a pungent, bitterish taste and a neutral reaction. 
It consists chiefly of methyl-nonyl-ketone (CH 3 .CO.C 9 H 19 ). Its 
action is similar to that of oil of savine, but is less powerful. 
Two cases of non-fatal poisoning from an unknown quantity of 
decoction of the root, in females, followed by miscarriage, are 
recorded.* Dose, gtt. ij-v every 3 or 4 hours. 

TANACETUM TANSY. 

Tansy is the leaves and tops of Tanacetum vulgare {Nat. Ord. 
Composite), an herbaceous, perennial plant, indigenous to Europe 
but cultivated in our gardens and growing wild about waste 
places. 

The leaves are bipinnatifid, the segments cut-toothed, smooth, 
dark green ; the heads yellow, in a dense corymb, appearing in 
summer; the odor is strongly aromatic and the taste pungent 
and bitter. It contains a volatile oil, tanacetin (a bitter principle), 
resin, tannin, etc. 

Effects and Uses. — When the oil is given to animals in large 
doses, it causes vomiting, dilated pupil, muscular twitchings, 
followed by clonic convulsions and a cataleptic state with death 
from paralysis of the respiratory muscles. The lungs were found 
engorged, the left side of the heart empty and the kidneys 
much congested. In man, small doses cause a sensation of 
heat in the epigastrium, flushing of face, giddiness and diuresis. 
In toxic doses it causes burning pain, vomiting and sometimes 
purging, loss of consciousness, violent convulsions of cerebral 
origin and death from respiratory paralysis. Grave symptoms 
were produced by gtt. xv of the oil ; but as recovery took 
place after 5jss had been taken, the minimum fatal dose is not 
known. An unknown but large quantity of tansy-infusion f 
taken by an adult negress to produce abortion caused her death, 
the symptoms being incoherence of speech, contracted pupils, 



* " Woodman and Tidy," 1882, p. 358. 
f Med. Times and Gazette, April, 1 86 1, 377. 
26 



402 MATERIA MEDICA ECCRITICS. 

hebetude, and finally paralysis of the voluntary muscles, with 
those of deglutition, and coma. The uterus was not affected, 
and stimulants failed to arouse her. 

It has been employed as a stimulating emmenagogue, but is an 
unsafe remedy. It has also been used to produce abortion, 
taken with criminal intent. Dose, of the powder, gr. x-xxx in 
infusion ; of the oil, ™KJ-ij. 

The following unofficinal drugs enjoy a reputation as emmena- 
gogues :— 

Apiol or Parsley-Camphor is obtained from the volatile oil 
of the root of Petroselinum sativum {Nat. Ord. Umbelliferae). It 
occurs as a colorless or yellowish oil, having a strong odor of 
parsley and a pungent taste, and is soluble in alcohol, ether and 
chloroform, but not in water. It is said to be a mixture of sev- 
eral constituents (Maisch). It has been used in amenorrhcea of 
functional origin, especially when due to anaemia, and is believed 
to be a stimulant to the ovaries. In neuralgic dysmenorrhea, it 
has also been used with success. It is given in doses of gtt. 
v-vj enclosed in gelatin-capsules, morning and evening for four 
or five days before the expected menstrual period. 

Polygonum Hydropiperoides (Water-Pepper or Smartweed) 
{Nat. Ord. Polygonacese) is an indigenous herb, growing abun- 
dantly in moist places, with lanceolate, minutely pellucid-punctate 
leaves, and slender spikes of greenish or whitish flowers. It con- 
tains polygonic acid, etc. 

Effects and Uses. — It is a cardiac stimulant, diaphoretic, diuretic 
and expectorant, stimulates the menstrual flow, and is aphrodisiac; 
in large doses it causes nausea, vomiting and purging; and when 
applied locally, it is an irritant, exciting inflammation and vesica- 
tion when rubbed on the cutaneous surface. 

It is strongly recommended by Dr. Eberle in functional amenor- 
rhcea and by others in functional impotence, and Dr. B. Wood- 
ward has used it with advantage in diarrhcea and dysentery. It 
has also been used as a diuretic to promote the expulsion of 
small calculi from the kidney and in gravel, and locally as a 
counter-irritant. A fluid extract may be used in doses of ^x-f5j. 



ALTERATIVES. 4O3 

CLASS III.— HEMATICS. 

ORDER I. HEMATINICS. 

This order (from alfiar(va f the red coloring matter of the blood) 
includes only the Preparations of Iron, or Chalybeates. The 
chalybeates increase the number of blood-corpuscles, or the 
amount of hematin in the blood, and are employed therapeutically 
in diseases dependent on a deficiency of these elements. They 
belong eminently to hematics (or medicines which occasion 
changes in the condition of the blood) ; but as they possess also 
general and local tonic effects, independent of their action on the 
blood, they have been classed and treated of among the mineral 
tonics (see p. 157). 

ORDER II. ALTERATIVES. 

Alteratives may be defined' to be medicines which produce such 
a modification of the nutritive processes as enables the vital prin- 
ciple to restore healthy action in morbid conditions of the system. 
The modus operandi of these medicines is not understood. Per- 
haps their effects are owing to a correcting influence on the 
quality of the circulating fluid (thus, in inflammations they may 
act by diminishing the abnormal quantity of fibrin in the blood, 
rendering its red corpuscles less disposed to aggregation, and 
decreasing the number and adhesiveness of its white globules) ; 
perhaps their curative operation is of a substitutive character (by 
setting up an antagonistic action which takes the place of diseased 
action in the system) ; or perhaps they may attack diseased cells, 
causing their disintegration and rapid removal from the body by 
means of the excretions. 

Under the influence of alteratives the secretions and exhala- 
tions are increased, the textures softened, and morbid growths 
and deposits are absorbed. The exudation of plastic or coagu- 
lable lymph is checked, and, as a consequence, also the formation 
of false membranes, and visceral and glandular enlargements and 
indurations are diminished and often disappear. 

If pushed too far, the alteratives soften and even destroy the 
textures, impoverish the blood so as to interfere with the func- 
tions of nutrition, and produce a condition of marasmus and 
cachexia. 



4O4 MATERIA MEDICA HEMATICS. 

Their principal therapeutic employment is as antipJilogistics or 
resolvents. The mercurials are chiefly employed in acute inflam- 
mations ; the preparations of iodine in chronic inflammations. 
Mercurials are used in acute sthenic inflammations, especially in 
such as have a tendency to terminate in effusions of lymph which 
would seriously interfere with the function of the part, by form- 
ing adhesions or false membranes. The iodic preparations are 
adapted to inflammations of a chronic character, and .are particu- 
larly serviceable in indurations or enlargements of glands and 
organs, and in affections of the bones and fibrous tissues. 

Owing to the injurious results which follow the prolonged 
exhibition of alteratives, they are to be administered with caution, 
and their effects closely watched. 

HYDRARGYRI PRiEPARATA PREPARATIONS OF MERCURY. 

Metallic mercury or quicksilver is obtained principally from the 
red sulphide {cinnabar"). The chief supply of quicksilver was 
long derived from Spain and Austria, but the markets of the 
United States are now furnished from New Almaden, in Califor- 
nia. Mercury is an odorless, tasteless, volatile, liquid metal, of a 
whitish color. Its atomic weight is 199.7 ; its symbol is Hg. 

While it retains the liquid metallic state, mercury is inert ; but 
when taken internally it sometimes combines with oxygen in the 
alimentary canal, and thus becomes active. A non-fatal case in 
which Sivss of quicksilver was taken to produce abortion is 
reported by Sir G. D. Gibb *; the chief symptom was trembling 
palsy ; there was no salivation, coloration on the gums, nor action 
upon the uterus. In the state of vapor it frequently proves inju- 
rious, in some instances exciting salivation, ulceration of the 
mouth, etc., in others inducing a peculiar affection of the nervous 
system termed shaking palsy {tremor mercurialis) y which is often 
attended with loss of memory, vertigo and other evidences of cere- 
bral disturbance, and sometimes terminates fatally. Workmen 
in quicksilver are liable to this affection. It is supposed by some 
chemists that the activity of mercurial emanations is owing to the 
oxidation of the metal before it is inhaled ; by others, that, in the 
finely-divided state in which it exists as a vapor, it is in itself 
poisonous. 

* The Lancet, 1873, p. 339. 



ALTERATIVES PREPARATIONS OF MERCURY. 405 

All the compounds of mercury possess activity. Some of them 
are violent caustic poisons ; all of them are more or less irritant. 
When the mercurials are taken internally their effects vary with 
the quantity administered. In small and repeated doses, their 
influence is first shown in an increase of the activity of the 
secernents and exhalants. The cutaneous, mucous, biliary, sali- 
vary, urinary, and probably also the pancreatic secretions are all 
increased in amount, and at the same time the absorbent system 
becomes more active, so that accumulations of fluids, morbid 
enlargements, indurations, etc., will often disappear. 

Mercury increases the flow of bile. Most of the mercurial 
preparations probably accomplish this merely in a mechanical 
manner, i. e., by causing reflex contraction of the gall-bladder and 
ducts, due to the irritation of the mucous membrane of the duo- 
denum ; but corrosive sublimate would seem, from the experi- 
ments of Rutherford and Vignal, to have considerable power as 
a stimulant of the hepatic secretory apparatus. 

When mercury is given in larger doses, these effects are more 
intense. The proportion of red corpuscles * is diminished. The 
mucous membrane of the mouth and the salivary glands not only 
take on increased secretory action, but become irritated and 
inflamed. The gums first show the mercurial influence, and are 
tender and tumefied ; the whole mouth soon becomes sore ; the 
tongue is swollen ; and the saliva and buccal mucus flow abun- 
dantly, sometimes to the extent of several pints a day. At the 
same time the breath acquires a peculiar fetidity, and the patient 
perceives a metallic taste in the mouth. The resolvent action of 
mercury is now still more obvious than when its impression is 
milder, and considerable emaciation usually ensues from inter- 
ference with nutrition and the absorption of fat. Formerly these 
effects, which are termed sialagogue (from the excessive flow of 
saliva), were commonly produced for the cure of diseases, and, 
as a general rule, gradually subsided, leaving the health unim- 
paired. When, however, the use of mercury is pushed too far, or 
it is administered to persons peculiarly susceptible to its action, 
a train of very serious symptoms ensues — as excessive salivation, 

* " Report of Edin. Committee on the Action of Mercury on the Biliary Secre- 
tions," 116, 2d ed., 1874. Hughes- Bennett. 



406 MATERIA MEDICA HEMATICS. 

ulceration of the mouth, sloughing of the gums, loosening of the 
teeth, and occasionally necrosis of the alveolar processes. A 
peculiar febrile condition called mercurial fever, diarrhoea, skin 
diseases, neuralgia, rheumatism, disorder of the nervous system, 
and marasmus, are other symptoms which are frequently noticed 
after the abuse of mercury. 

After its absorption mercury (and there is no doubt that it is 
absorbed,* since it has been found in the blood, saliva, liver, etc.) 
produces several important changes in the quality of the blood. 
Exceedingly minute doses given for some time, but not too fre- 
quently repeated, increase the proportion of red corpuscles in 
this fluid, and the bodily weight. This has been proven by 
Schlesinger f in an elaborate series of investigations upon dogs. 
Immediately upon the establishment of salivation, the blood 
exhibits an increase in the quantity of fibrin and red corpuscles ; 
but at a later period it loses color, consistence and coagulability, 
and the relative proportion of albumen, fibrin and corpuscles is 
diminished. This antiplastic action on the blood renders mercu- 
rials valuable as antiphlogistic remedies. It is in part eliminated 
by the urine, feces and saliva. 

Medicinal Uses — Liquid metallic mercury was formerly admin- 
istered to remove mechanical obstructions of the bowels, but its 
use has been abandoned. The preparations of mercury are em- 
ployed therapeutically with various objects: — 

1. As indirect tonics and cholagogues — with a view to their 
action on the secretions — in dyspepsia and constipation accom- 
panied with torpor of the liver, in gout, rheumatism, chronic skin 
diseases, etc. Blue pill, mercury with chalk, and calomel, are 
employed with this view : the two former are preferred as least 
irritating. 

2. As antiphlogistics. Mercury was formerly given in nearly 
all cases of sthenic inflammation with a tendency to plastic 
effusion. At present, however, its use as an antiphlogistic is 
principally restricted to acute inflammation of the serous mem- 
branes of sthenic type during the stage of exudation, and after 
the plastic effusion has ceased to be poured out, with a view to 



* " Mat. Med. and Therapeutics," Stille, n, i860, 782, quoted, 
-j- Arch, filr exper. Path. ti. Pharmak., XIII, 317. 



ALTERATIVES PREPARATIONS OF MERCURY. 407 

prevent its organization and facilitate absorption. In this way- 
it is given in pleuritis, pericarditis and peritonitis, and with a 
similar view in pneumonitis and iritis. Many writers, however, 
relying on other remedies, deprecate the use of mercurials in the 
treatment of these diseases, with the exception of iritis, in which 
they are universally acknowledged to be of benefit. Minute 
doses of mercurials, frequently repeated, are highly recom- 
mended in acute glandular affections about the throat and neck, 
as tonsillitis, parotitis, etc. In acute sthenic dysentery, a mer- 
curial — especially calomel — may often be given with advantage. 
When given with a view to their antiplastic effects, it is no 
longer thought necessary to cause profuse salivation ; it is suffi- 
cient to produce constitutional effects as manifested by a metallic 
taste in the mouth, slight tumefaction of the gums and slight 
tenderness of the teeth when knocked together forcibly. During 
the maintenance of this condition the patient should use warm 
clothing, avoid exposure to cold, and take light and nourishing 
food. If salivation or ulceration occur, the drug must be stopped 
and astringent gargles, as brandy and water, solutions of chlor- 
inated soda or lime, alum, etc., may be employed. In cases of 
sloughing sores, silver nitrate, or the mineral acids should be 
applied. Gastro-enteric irritation is to be treated with laxatives 
and opiates. The mercurial cachexia requires change of air, 
generous diet, tonics, etc. When the system is contaminated 
with mercury, it may be eliminated by the use of potassium 
iodide, which forms soluble compounds with the mercury 
retained in the economy. Mercurials are contra-indicated in all 
asthenic inflammations, serous exudations, or where much 
debility exists. 

3. As antisyphilitics. Mercury has long been regarded as the 
only reliable antisyphilitic agent. So far no satisfactory explana- 
tion has been made as to its mode of action. Hughes-Bennett (loc. 
at.) and Wilbouchewitch * have shown that the blood of syphilitics 
who were taking mercury underwent an increase in the number of 
red globules. It has no direct curative influence on the primary 
symptoms ; but after the system has been contaminated with the 
syphilitic virus, mercury is the most certain and rapid means of 

* Arch, de Physiol. Norm, et Pathol., 2d ser., 1, 1874, 509. 



4<d8 materia medica — HEMATICS. 

destroying it. Formerly, wherever the chancre, with distinct 
induration (which is indicative of constitutional taint), was pre- 
sent, mercurials were administered, but, as it is now generally 
conceded that the initial lesion is but a local manifestation of a 
constitutional disease, in other words, that the patient's system is 
affected with the disease when the chancre first appears, and as 
mercury does not prevent the secondary symptoms, but merely 
modifies them in such a manner that no prognosis can be formed 
from the variety or date of appearance of the syphilides, it is 
recommended to withhold mercurials until the secondary lesions 
manifest themselves (H. M.). Some high authorities, however, 
adhere to the rule of administering mercury from the first appear- 
ance of the chancre. Hutchinson's* " abortive treatment of syph- 
ilis " consists in the administration of gray powder (a. v) as soon 
as the diagnosis is verified by the induration around the sore, 
for the purpose of entirely suppressing the secondary symptoms. 
He believes mercury is antagonistic to the microbe of syphilis. 
Von Zeissl's f teaching is to wait eight or ten weeks after the 
first eruption has appeared, and then to give it by inunction. I do 
not agree with this doctrine, for it seems irrational to allow the 
disease to gain so much headway (C. B.). Ross % advises it to be 
given "when the base of the primary ulcer is thickened," as it 
stimulates the tissues surrounding the ulcer to increased action, 
but he offers no evidence to prove the latter statement. I am of 
opinion that as soon as the diagnosis of syphilis is positively made 
certain, and in this statement I am in accord with the view of Ver- 
neuil§, and Hutchinson (loc. cit.),by the character of the ulcer, its 
period of incubation, the presence of a non-suppurating bubo, and 
possibly by confrontation, it is time to begin a mercurial course, 
small in dose, continued usually for a lengthy period (two and a 
half years), occasionally intermitted, and in semi-metallic form, 
as blue mass or gray powder (C. B.). In the treatment of heredi- 
tary syphilis, a mercurial course is indispensable. In tertiary 
syphilis small doses of corrosive sublimate are often combined 
with potassium iodide with better effects than when the iodide is 
given alone ; after the tertiary symptoms have disappeared the 



* Lancet, Feb., 1888, p. 372. f « Path, and Treat, of Syphilis," 1886, p. 335. 

% The Practitioner, v, p. 220. \ Bull. Gen. de Therap., Oct., 1887. 



ALTERATIVES PREPARATIONS OF MERCURY. 4O9 

mercurials should be continued for eighteen months, with the 
occasional intermission of the treatment for two or three weeks. 
Mercurials may be used not only internally, but by inunction and 
by fumigation, for Dr. Fiirbringer has shown that, although 
metallic mercury will not pass through the skin, yet when rubbed 
into the sebaceous follicles the sebaceous matter converts it into 
a soluble mercurous compound, which is then readily absorbed, 
and by hypodermic injection. 

Blue pill and calomel are the antiplastics principally resorted 
to ; as antisyphilitics, both iodides, corrosive sublimate, gray pow- 
der and calomel are employed. In administering mercurials for 
their sialagogue action, we sometimes observe a cumulative effect : 
they may be exhibited, particularly to children, for some time 
without result, when suddenly the most violent symptoms of mer- 
curial saturation will be developed. 

4. As purgatives. The employment of calomel and blue pill, 
as cathartics and anthelmintics, has been previously noticed (see 
page 354). 

The following are the preparations of mercury which are em- 
ployed medicinally : — 

1. Metallic Mercury. — When intimately mixed with pul- 
verulent or fatty bodies, mercury loses its liquid character — is 
said to be killed, extinguished or mortified — and acquires medi- 
cinal activity. Its activity is probably owing to its reduction to a 
state of minute division, which enables it to enter into combinations 
in the stomach. The officinal preparations of metallic mercury 
are : Massa hydrargyri (mass of mercury), unguentum hydrargyri 
(inercwdal ointment), emplastrum hydrargyri (inercurial plaster), 
emplastrum ammoniaci cum hydrargyro (ammoniac plaster with 
mercury), hydrargyrum cum creta (mercury with chalU). 

2. Oxides. — Hydrargyri oxidum flavum (yellow mercurial 
oxide), unguentum hydrargyri oxidi flavi (ointment of yellow mer- 
curial oxide), oleatum hydrargyri (oleate of mercury), hydrargyri 
oxidum rubrum (red mercurial oxide), unguentum hydrargyri oxidi 
rubri (ointment of red mercurial oxide). 

3. Chlorides. — Hydrargyri chloridum mite (mild mercurial 
chloride, or calomel), hydrargyri chloridum corrosivum (corrosive, 
or mercuric chloride, or corrosive sublimate). 



410 MATERIA MEDICA HEMATICS. 

4. Iodides. — Hydrargyriiodidum viride [green mercurial iodide), 
liydrargyri iodidum rubrum (yed mercurial iodide). 

5. Hydrargyri cyanidum (mercurial cyanide). 

6. Hydrargyrum ammoniatum (ammoniated mercury), unguen- 
tum liydrargyri ammoniati (omtment of ammoniated mercury). 

7. Hydrargyri sub sulphas flavus [yellow mercurial subsulphate). 

8. Hydrargyri sulphidum rubrum (red mercurial sulphide). 

9. Nitrates. — Unguentiim liydrargyri nitratis (ointment of mer- 
curial nitrate), liquor hydrargyri nitratis (solution of mercurial 
nitrate). 

Massa Hydrargyri (Mass of Mercury). This preparation, gen- 
erally known as blue mass, is made by rubbing mercury (33 parts) 
with honey of rose (34 parts) and glycerin (3 parts) till all the 
globules disappear ; then adding powdered glycyrrhiza (5 parts) 
and althaea (25 parts), and beating the whole into a mass. The 
trituration is now generally effected by machinery — usually by 
steam power. It is a soft, dark-blue mass, of a convenient con- 
sistence for making it into pills. The mercury is in a state of 
minute division, and is chemically unaltered, though, perhaps, 
a. very small portion of it is in a state of oxidation. The prepa- 
ration changes color from being kept, becoming of an olive and 
even reddish tint, in consequence of the further oxidation of the 
metal. As it is often adulterated, it is important that it should 
be purchased of a reliable house. 

Effects and Uses. — In full doses (gr. v-xv) blue pill acts as a 
laxative ; when given for this purpose it is usually followed in a 
few hours by a saline cathartic. In doses of gr. j-ij-iij, repeated 
at proper intervals, it is employed as an alterative or antiphlogistic. 
When it moves the bowels, opium is combined with it. It may 
be pleasantly given suspended in mucilage or syrup. In the case 
of an adult female,* gr. xviij caused death, the chief symptom 
being profuse salivation — a very exceptional instance. Blue 
mass is an efficient antisyphilitic agent, and is often well com- 
bined with iron and quinine as in the following prescription : 
1^ Massae hydrargyri, gr. \~\ ; ferri sulphatis exsiccati et 
quininae sulphatis, aa gr. j ; extracti opii, gr. \. M. et ft. pil. j. 

* The Lancet, 1838, 215. 



ALTERATIVES PREPARATIONS OF MERCURY. 4 1 I 

Sig. — One pill half hour after meals ; it has the advantage also of 
being in the metallic state, which was the form preferred by the 
late Dr. Bumstead. 

Unguentum Hydrargyri {Mercurial Ointment) (called also bine 
ointment) is made by rubbing mercury with compound tincture 
of benzoin and mercurial ointment, then adding suet and lard, 
previously melted together, and continuing to rub until the 
globules disappear. It is an unctuous, fatty body, of a bluish- 
gray color, consisting of equal weights of fatty matter and finely- 
divided mercury. A very small portion of mercurous oxide is 
perhaps present, and, as the ointment becomes darker by age, a 
further oxidation of the mercury probably takes place. 

Effects and Uses. — Mercurial ointment, when either swallowed 
or rubbed into the integuments, slowly produces the constitutional 
effects of mercury ; locally, it has but little irritant effect. It is 
scarcely ever used internally in the United States or Great Britain, 
though in France it is highly esteemed as a sialagogue, in the 
dose of gr. ij, repeated. Externally it is used to mercurialize the 
system by friction ; to disperse non-malignant tumors ; as a 
dressing to syphilitic sores ; to destroy pediculi ; and to prevent 
suppuration and the pitting of smallpox. When mercurial 
inunction is about to be practiced, the part to which the ointment 
is to be applied should be washed with castile soap and warm 
water to free the skin from oily matters. The ointment may be 
thoroughly rubbed into the soles of the feet every night for a 
week, when the inunction should be omitted for three nights, 
after which the process may be repeated. About gr. xv-xxx 
are required each night, and it is best to apply it to the feet 
alternately. Sigmund, of Vienna, the great advocate for this plan 
of treatment, recommends that the inunctions be applied to differ- 
ent parts of the body ; thus, during five successive nights this 
treatment would be practiced on the legs, on the thighs, on the 
abdomen and sides of the chest, on the back, on the arms, and 
on the sixth night he would apply the inunction to the legs again. 
The rubber should wear a glove to guard against the absorption 
of mercury. This plan of treatment is troublesome and filthy, 
and has not been generally used, but in certain cases, where 
mercury cannot be taken internally, it is of much value. 

Emplastrum Hydrargyri {Mercurial Plaster) is made by rub- 



412 MATERIA MEDICA HEMATICS. 

bing 30 parts of mercury with 10 parts of olive oil and resin 
each, previously melted together, till the globules disappear, and 
then adding 50 parts of melted lead-plaster. It is used as a dis- 
cutient of scrofulous and syphilitic enlargements, to enlarged 
joints, to prevent pitting in smallpox, etc., and is applied to the 
side in chronic hepatitis ; it may induce salivation. The plaster 
of ammoniac with mercury (emplastrum ammoniaci cum hydrargyrd) 
is more stimulating than the foregoing. 

Hydrargyrum cum Creta {Mercury with Chalk) (called also 
gray powder) is prepared by rubbing 38 parts of mercury with 
50 parts of prepared chalk and 12 parts of sugar of milk, till all 
the globules disappear. It is a grayish powder, containing mer- 
cury chiefly in a state of minute division. In full doses it is a 
gentle laxative, milder even than blue pill ; in smaller doses it 
is an excellent alterative ; and the chalk renders it antacid. It 
is employed chiefly as an alterative in infantile cases. Dose, for 
adults, gr. v-xx ; for children, gr. ij-iij to gr. viij-x, in powder, 
and not in pills, as in the latter form the mercury becomes 
squeezed out of the chalk. In congenital syphilis gr. y^ may be 
given three times a day. Gray powder is Mr. J. Hutchinson's* 
favorite remedy in syphilis, as follows : 3^ Hydrargyri cum creta, 
pulveris ipecacuanhas et opii, aa gr.j. M. et ft. pil. 1. Sig. — One 
every 6, 4, 3, or even 2 hours. He advises this preparation of 
mercury to be used for a long period, but always in small doses. 
The chlorides and nitro-hydrochloric acid are incompatible with 
all the metallic preparations of mercury. 

Hydrargyri Oxidum Rubrum (Red Mercuric Oxide) (HgO). 
It is made usually by dissolving mercury in diluted nitric acid, 
with a gentle heat, by which mercuric nitrate is formed ; and the 
nitric acid is afterward decomposed and driven off by calcination. 
The mercuric oxide, commonly called red precipitate, occurs in 
small, shining scales, of a brilliant red color, with a shade of 
orange. It has an acrid taste, and is nearly insoluble in water. 
Its effects are those of a powerful irritant, and when taken inter- 
nally, even in small doses, it excites vomiting and purging ; in 
large doses, gastro-enteritis. An instance of non-fatal poison- 
ing f is recorded in the case of a female aged 15, who swallowed 

* " On Syphilis," 1887, p. 51. f Irish Hosp. Gazette, I, 1873, p. 308. 



ALTERATIVES PREPARATIONS OF MERCURY. 413 

probably o%, this quantity being followed only by some ab- 
dominal pain, mercurial fetor of breath, sore mouth and gums. 
It is rarely or never used internally (dose, gr. ^ \ ) ; externally 
it is applied as an escharotic, either in powder or ointment, to 
chancres, indolent ulcers, etc. Unguentum hydrargyri oxidi rubri 
{ointment of red mercuric oxide) consists of red oxide (io parts) 
mixed with ointment (90 parts) ; it is a very useful stimulating 
ointment in indolent ulcers, porrigo and ophthalmia. 

Hydrargyri Oxidum Flavum {Yellow Mercuric Oxide) is made 
by mixing a solution of corrosive sublimate with solution of 
potassa ; potassium chloride is formed in solution, and mercuric 
oxide (HgO) is precipitated as an orange-yellow powder, which, 
on being heated, assumes a red color. The yellow oxide is with- 
out odor, of an acrid taste, is very slightly soluble in water, and 
is insoluble in cold alcohol and ether. This preparation is pre- 
ferred for some purposes to the red oxide, owing to its greater 
purity, and especially to its occurring in the form of a completely 
amorphous powder, exhibiting no evidence of crystalline particles 
even under the microscope. This gives it a superiority, as a local 
application to the conjunctiva, in diseases of the eye, over the 
red oxide, which, from the crystalline character of its particles, 
causes more or less irritation. Unguejitum hydrargyri oxidi flavi 
{ointment of yellow mercuric oxide) consists of yellow oxide, 10 
parts, mixed with ointment, 90 parts ; an efficient application in 
opacity and ulcer of the cornea (C. B.). Oleatum hydrargyri 
(oleate of mercury) consists of yellow oxide, 10 parts, dissolved 
in oleic acid, 90 parts, by means of heat. It may be used by 
inunction as a substitute for mercurial ointment. For this pur- 
pose 20 per cent, in solution may be painted on the part, or it 
may be mixed with petrolatum in the same proportion, and 
applied with mild friction. In infantile cases an ointment con- 
taining 5 per cent, of the oleate may be applied by means of 
roller bandages once a day. H. W. Stelwagon * finds the oleate 
inferior to blue ointment when applied locally for its consti- 
tutional effects, but lauds its use in ring-worm of the scalp. 
Yellozv wash (a favorite application to phagedenic venereal ulcers) 
consists of yellow mercuric oxide suspended in a weak solution 

* Am.Journ. Med. Sci., Oct., 1885. 



4H MATERIA MEDICA HEMATICS. 

of calcium chloride, and is made by adding corrosive sublimate 
5j to lime solution Oj. Black wash (a favorite application to 
chancres and mucous patches) is an impure mercurous oxide 
(Hg 2 0) in a weak solution of calcium chloride, and is made by 
adding calomel 5j to lime solution Oj, In the treatment of 
vesicular eczema, an efficient plan is to cleanse the parts with 
black wash, and then to apply zinc oxide ointment — all to be 
repeated according to circumstances. 

Hydrargyri Chloridum Mite {Mild Mercurial Chloride). 
This preparation (mercurous chloride), well known as calomel 
(Hg 2 Cl 2 ), is made by subliming a mixture of mercurous sulphate 
and sodium chloride (common salt) ; a double decomposition 
takes place, by which mercurous chloride and sodium sulphate 
are formed. The mercurous sulphate is previously obtained by 
boiling mercury in sulphuric acid, and afterward triturating the 
resulting mercuric sulphate with mercury. Calomel, as thus pro- 
cured in mass, is liable to contain a little corrosive sublimate. It 
should be reduced to powder, and washed repeatedly with boil- 
ing distilled water until the absence of a white precipitate with 
ammonium hydrate shows that the corrosive sublimate has been 
removed. With a view of obtaining calomel in a state of very 
minute division, its vapor is condensed in a receiving vessel 
filled with steam, whereby it takes the form of a very fine 
powder, and is perfectly free from corrosive sublimate. The 
calomel thus prepared (known as Jewell's or Howard's calomel) 
is finer and more active than can be obtained by levigation and 
elutriation. 

Calomel, as usually manufactured by sublimation, is in the 
form of white, fibrous, crystalline cakes. It may be obtained in 
the shape of quadrangular prismatic crystals. As found in the 
shops it is a light-buff or ivory-colored powder, tasteless, inodor- 
ous, insoluble in water, alcohol and ether, unalterable in the air, 
but blackening by exposure to light, showing decomposition. It 
should be kept in bottles painted black or covered with black 
paper. Jewell's calomel is a perfectly white powder. When pure, 
calomel is completely vaporizable by heat ; it strikes a black 
color, free from reddish tinge, with solutions of the fixed alka- 
lies; and should not, when digested with water, form a white 
precipitate with ammonia, unless it contain corrosive sublimate. 



ALTERATIVES PREPARATIONS OF MERCURY. 415 

Incompatible s. — The alkalies, alkaline earths, alkaline carbon- 
ates, soaps, and hydrosulphates are incompatible with calomel. 
Nitro-hydrochloric acid should not be prescribed with it, for 
fear of generating corrosive sublimate. Preparations containing 
hydrochloric acid, and potassium, ammonium or sodium chlo- 
ride, produce the same change. It is asserted that calomel is 
converted into corrosive sublimate in the stomach by the hydro- 
chloric acid which it there encounters, but there are many reasons 
for rejecting this hypothesis, and more probably it unites with 
the albuminous peptones, forming a compound which is soluble 
in the gastric fluid. 

Effects and Uses. — Calomel produces the effects of the mercurials 
already described, causing bilious stools, not from direct stimula- 
tion of the liver, but probably in a reflex manner ; it stimulates 
too the intestinal glands, and in purgative doses proves a valuable 
anthelmintic. It agrees well with the stomach, and will often be 
borne when other purgatives would not be tolerated. From the 
certainty and mildness of its operation it is more employed than 
any of the other preparations of mercury, although blue pill, 
which, if less certain, is milder, is preferred under some circum- 
stances. Calomel has been frequently taken in very large doses 
without any bad effects ; but instances are recorded in which, 
in excessive quantity, it has acted as an irritant poison. In the 
case of a boy * aged 14, gr. vj, and in the cases of two lads f of 
12 and 15, gr. xv caused death ; but such examples must be con- 
sidered as very unusual. As a purgative it is employed in doses 
of gr. yj-xij in fevers and many other affections ; gr. ss-j at bed- 
time will often prove sufficiently purgative in the morning ; as 
an anthelmintic, in the same doses ; and in both cases it is to be 
followed in a few hours by a saline draught, castor oil or senna. 
Calomel is often given in combination with other cathartics, as 
jalap, rhubarb, aloes, scammony, colocynth and gamboge. In the 
treatment of syphilis it is the favorite remedy of many, and may 
be given gr. y^-, y 1 ^, 3 to 4 times daily. As an antiphlogistic in 
inflammatory cases, calomel is given in doses of gr. ss-j every 
one, two or three hours ; as an eccritic, in these doses twice or 

* "Med. Jurisprudence," Taylor, 5th ed., p. 98. 

f " A Treatise on Poisons," Christison, 4th ed., p. 428, 



41 6 MATERIA MEDICA HEMATICS. 

thrice a day. In the dose of gr. yV~J> frequently repeated, it is 
one of the best means of checking obstinate vomiting ; for this 
purpose gr. y 1 -^ with sodium bicarbonate gr. j may be sprinkled 
on the tongue every half hour, which will often be of great service 
in the irritable stomach following the ingestion of indigestible 
food, after the contents of the stomach have been evacuated, and 
in cholera morbus. It is sometimes added to other medicines 
to increase their action on the secretions, as to squill or digitalis, 
and has recently been lauded as a diuretic in cardiac dropsy*. 
Cohn's f clinical investigations, however, have not led him to 
place much reliance on calomel as a diuretic in cardiac and other 
dropsies. As the diuretic action of the mercurial preparations 
seems to depend upon their stimulant action on the liver, leading 
to the increased formation of urea, as in the case of other chola- 
gogues, t and as Rutherford has shown that calomel is not a 
true hepatic stimulant, it is probable that either some of the 
corrosive chloride was present in the calomel, causing diuresis, or 
that the latter was transformed into that salt in the alimentary 
canal§. To children, calomel may be given in proportionally 
larger doses than to adults, and it rarely salivates them. In some 
cases of infantile diarrhoea, very minute doses of calomel, as 
gr. y\r, yj, ^, every hour or two, are highly efficacious. Exter- 
nally, calomel is applied in powder, as an errhine, in opacity of 
the cornea; and made into an ointment (5j to §j. lard), it is an 
excellent application in a variety of cutaneous affections. It is 
also used in the treatment of syphilis by fumigation. For this pur- 
pose calomel 5ss maybe volatilized in a water-bath placed beneath 
a cane-bottomed chair on which the patient is seated, without 
his clothes, but wrapped to the neck in blankets which should 
envelop the chair and apparatus. The patient should sleep in 
the blanket in which he was wrapped during the fumigation. 

Hydrargyri Chloridum Corrosivum {Corrosive Mercurial 
Chloride). This is mercuric chloride, commonly called corrosive 
sublimate (HgCL). It is made by subliming a mixture of sodium 

* Pester Med.-Chir. Presse, Nos. 51 and 52, 1885, Jendrassik. 
f " Ueber die diuret. Wirkung des Calomel," Inaug.- Dissert., Berlin, 1887. 
% Brit. Med. Journ., Feb., 1886, pp. 377 and 433. See abstract of Report by 
Dr. Noel Paten to Scientific Grants Committee of the British Medical Association. 
\ Practitioner, Sept., 1886, Spiller Locke. 



ALTERATIVES PREPARATIONS OF MERCURY. 417 

chloride and mercuric sulphate (which is previously obtained by 
boiling mercury with sulphuric acid) ; double decomposition 
takes place, resulting in the formation of mercuric chloride ancf 
sodium sulphate. Corrosive sublimate occurs in the form of 
white, semi-transparent, crystalline masses, permanent in the air, 
inodorous, and of an acrid, styptic taste. It is soluble in 16 parts 
of cold water or 2 parts of boiling water, more soluble in alcohol, 
and still more so in ether. The aqueous solution, when exposed 
to light, is decomposed, with the precipitation of calomel and 
evolution of hydrochloric acid. It is incompatible with many of 
the metals, the alkalies and their carbonates, soap, lime-solution, 
tartar emetic, silver nitrate, the lead acetates, potassium and 
sodium iodides, the sulphides generally, syrup of sarsaparilla, 
and with many vegetable substances (as the bitters) and albumin- 
ous liquids (as milk, etc.). The tests for detecting corrosive sub- 
limate in solution are: I. A solution of potassa, soda or lime 
throws down a yellow precipitate ; 2. Potassium carbonate, a 
brick-red precipitate; 3. Ammonia, white ammoniated mercury; 
4. Potassium iodide, a bright scarlet-red mercuric iodide, readily 
soluble in excess of the precipitant; 5. Stannous chloride, in 
small amount, a white precipitate of calomel — in excess, a dark- 
gray precipitate of metallic mercury ; 6. Sulphureted hydrogen, 
or a sulphide, in minute amount, produces a whitish or gray pre- 
cipitate, and in large amount a black sulphide ; 7. If the solution 
be acidulated with hydrochloric acid and gently heated, bright 
copper-ioil, when plunged into it, becomes coated with a silvery- 
white deposit of mercury; and the metal may be afterward 
obtained by sublimation in a test-tube in the form of globules. 
The above is the method of obtaining mercury from organic 
mixtures, and it will detect about x J- Q of a grain (Wormley*). 
The deposit on the copper must be distinguished from deposits 
of arsenic and antimony, which are obtained in the same way. 
Under the microscope the mercury sublimate appears to be 
globular, the antimony amorphous, and the arsenic in octahedral 
crystals. 

Physiological Effects. — In medicinal doses, as gr. yg— i» corro- 
sive sublimate occasions a beneficial alterative effect, without any 

* " Micro- Chemistry of Poisons," 1885, p. 352. 
27 



41 8 MATERIA MEDIC A HEMATICS. 

obvious activity. It is a true hepatic stimulant of considerable 
power, increasing also the formation of urea and uric acid, and 
thus acting as a diuretic,* and likewise feebly stimulating the 
intestinal glands. Its continued use may cause salivation, but it 
has less tendency to produce this result than any other prepa- 
ration of mercury. Medicinal doses, if too large or too long 
continued, frequently produce gastro-enteric symptoms and the 
constitutional effects of mercury. In excessive doses corrosive 
sublimate is a violent caustic poison, from its affinity for the albu- 
men, fibrin and other constituents of the tissues. It acts very 
rapidly, producing the most intense gastro- enteritis, with violent 
vomiting and purging, abdominal pain and tenderness, bloody 
stools, with death from collapse, or, after a time, with convulsions 
and coma. The urine is albuminous or bloody, diminished in 
amount or suppressed. 

The precise fatal quantity cannot be stated, for in a number of 
cases the toxic amount has varied widely ; for instance, Taylor f 
reports the death of a child from gr. iij ; Herapath % records a 
fatal case from gr. xx in solution, in a man ; while a girl § of 
eighteen recovered after swallowing about gr. xix. 

The best antidote is albumen (in the form of white of eggs) ; 
or, if this is not attainable, gluten (in wheaten flour) or casein 
(in milk) may be substituted. Ferrous sulpiride (if given imme- 
diately), and a mixture of iron filings (two parts) with gold dust 
(one part), also decompose corrosive sublimate. In cases of 
poisoning, the stomach must be evacuated as soon as possible, 
and the after-treatment consists in the free use of demulcents, 
and opiates. 

Medicinal Uses. — Corrosive sublimate is used chiefly as an 
alterative in secondary syphilis, both by the stomach and by 
hypodermic injection, and also in cutaneous and rheumatic 
affections ; it is a good remedy, too, in chronic diarrhoea and 
dysentery with slimy and bloody discharges. In tertiary syphilis 
it is combined advantageously with potassium iodide, as in the 
following : ty Hydrargyri chloridi corrosivi, gr. iss ; potassii 
iodidi, 5ij ; elixir aurantii, foij ; aquae, ad f Syj. M. Sig. — f3ij, in 



* Practitioner, Sept., 1886. f "Medical Jurisprudence," 1865, p. 225. 

% The Lancet, 1845, P- 6 5°- \ Guy's Hosp. Reports, 185 1, p. 212. 



ALTERATIVES PREPARATIONS OF MERCURY. 419 

water, t. d., after meals. The dose, when alone, is gr. yV~i three 
or four times a day, after meals, in pill ; or, if in solution, disguised^ 
by elixir of orange. It has also been used hypodermically. For 
this purpose various solutions have been used. 1^ Hydrargyri 
chloridi corrosivi, gr. j ; aquae destillatse, f§j. M. Of this solu- 
tion tt^x contain gr. -£%. As the injection of corrosive sublimate 
is followed, in many instances, by inflammation and abscess, and 
as it seems to have no decided advantage over the other methods, 
we do not advise its adoption. 

When used hypodermically mercury is claimed to be more 
energetic, efficient, and rapid in its action than when administered 
either by the mouth, by inunction, or by fumigation. 

M. Martineau, who has employed it largely in syphilis, declares 
there is no pain, neither phlegmon nor abscess, no stomatitis 
(without there was previously an unhealthy condition of the 
buccal mucous membrane), and no gastro-intestinal disturbance, 
when the solution is neutral, the needle fine and very sharp, and 
the injection made in the dorsal region. Though highly recom- 
mended by numerous syphilographers, the hypodermic use of 
mercury has not gained much favor with the profession at large, 
and it is principally employed only when mercurials are not well 
borne by the mouth or by inunction. The average dose for 
hypodermic use is gr. xV~ tV- Externally it may be used as a 
caustic. It is destructive to the lower forms of life, and hence 
may be used as an antiseptic in weak solution (i part to 2000 
parts of water, or about gr. j-f Sivss, vide Antiseptics), instead 
of carbolic acid ; a weak solution (gr. J^-j-ij to water f Sj) is 
much employed as a wash to ulcers, an injection in gleet, a 
colly rium, etc. An ointment (gr. J^-j-ij to lard Sj) is a good 
application in porrigo, tinea, eczema, pityriasis, and skin diseases 
generally of parasitic origin. There is danger from the external 
application of corrosive sublimate to a large surface. 

In gonorrhoea after the acute stage has passed, corrosive sub- 
limate, gr. Y2~i m wa ter, fSviij is an excellent injection, and 
according to Koch is the most active agent with which to kill 
the gonococci. After the first trial the strength should be regu- 
lated just short of irritating the urethra. 

As a tineacide in ringworm the strength may be gr. iij-v in 
an ounce of compound tincture of benzoin, the solution to be 



420 MATERIA MEDICA HEMATICS. 

applied every few days with a brush. The parts should first be 
cleansed with sapo viridis, or an alkaline solution. The following 
is serviceable to destroy crab-lice : 3^ Hydrargyri corrosivi sub- 
limati, gr. vj ; acidi acetici diluti, f 5ij ; aquae, ad f §iv. M. Sig. — 
Apply with sponge morning and evening. The acid is added to 
dissolve the nidus of the lice around the base of each hair-shaft. 

Hydrargyri Iodidum Viride (Green Mercurial Iodide) (Mer- 
curous Iodide) (Hg 2 I 2 ) is made by rubbing mercury and iodine 
together, with the addition of a little alcohol. It is a greenish- 
yellow powder, insoluble in water and alcohol, but soluble in 
ether. By exposure to light it is partially decomposed, and 
becomes of a dark-olive color. 

Effects and Uses. — This mercurial exercises a specific influence 
over the lymphatic and glandular systems, and is employed in 
syphilis and scrofula. It is a favorite with many practitioners 
in the treatment of the syphilides : 3^ Hydrargyri iodidi viridis, 
gr. iv; morphinae sulphatis, gr. j. M. et ft. pil. xx. One of 
these pills may be given one-half hour after meals, and the dose 
gradually increased by one pill per day until tenderness of the 
gums or gastro-intestinal symptoms supervene, when the dose 
must be lessened. Dose, gr. j£- j ; it should not be given with 
potassium iodide, which decomposes it into the red iodide and 
metallic mercury. Externally, it is applied, in the form of oint- 
ment, to syphilitic ulcers, etc. 

Hydrargyri Iodidum Rubrum {Red Mercuric Iodide) (Hgl 2 ) 
is made by mixing solutions of potassium iodide and mercuric 
chloride, from which a double decomposition ensues, resulting in 
the formation of potassium chloride in solution, while red (mer- 
curic) iodide is precipitated. It is a scarlet-red powder, which 
becomes yellow when heated, insoluble in water, but soluble in 
boiling alcohol and solutions of potassium iodide and sodium 
chloride. It is a powerful irritant and caustic, and is employed 
in the same cases as the green iodide, though much more ener- 
getic. It is useful in rheumatism, especially when of syphilitic 
origin. Dose, gr. y 1 ^-, gradually increased to gr. ^, in pill or 
alcoholic solution ; or, still better, dissolved in a solution of 
potassium iodide. In late secondary or in tertiary syphilis the 
following prescription is often of service : 3^ Hydrargyri iodidi 
rubri, gr. iij ; potassii iodidi, oij J elixir aurantii, fgiij ; aquae des- 



ALTERATIVES PREPARATIONS OF MERCURY. 42 I 

tillatae, q. s. f§viij. M. et sig. Take a teaspoonful 3 times a day. 
Externally it may be used in the form of ointment (gr. xvj mixed 
with ointment Sj), and as an antiseptic agent (q. v.). 

Hydrargyri Cyanidum {Mercuric Cyanide). This salt is made 
by adding a solution of potassium ferrocyanide to sulphuric acid, 
by which hydrocyanic acid is produced, and this, being received 
in a vessel containing water and red mercuric oxide, generates 
water and mercuric cyanide (Hg(CN) 2 ). It is found usually in 
the form of permanent, prismatic, white and opaque crystals, of a 
disagreeable styptic taste, soluble in water, less so in alcohol. It 
is an active poison, two fatal cases being recorded by Christison,* 
one from gr. x, the other, gr. xxiijss. 

It is used as an antisyphilitic remedy, as a substitute for 
corrosive sublimate, over which it has the advantage of not pro- 
ducing epigastric pain, and of not being decomposed by the 
alkalies and organic substances. Dose, gr. -^ to y&. 

Hydrargyrum Ammoniatum (Atnmoniated Mercury) (NH 2 Hg 
CI). This preparation, commonly called white precipitate, is made 
by precipitating a solution of corrosive sublimate by ammonia ; 
ammonium chloride is formed in solution, and ammoniated mer- 
cury is thrown down. It is considered to be mercuric ammo- 
nium chloride. It is a perfectly white powder, insoluble in water 
and alcohol, decomposed by boiling water, inodorous, and has 
an earthy, afterward metallic, taste. It cannot be mixed with 
iodine, bromine or chlorine without decomposition. It is largely 
adulterated, chiefly with calcium sulphate. Its effects are poi- 
sonous, for Graham \ reports a case of non-fatal poisoning in a 
man who, having swallowed 5ij, was seized with vomiting and 
bloody diarrhoea, but no salivation nor sponginess of the gums 
occurred. It is used only as an external application, in the form 
of ointment {iinguentum hydrargyri ammoniati, 10 parts of ammo- 
niated mercury to 90 parts of benzoinated lard), to cutaneous 
eruptions, and to destroy pediculi and the tinea of ring-worm. 

Hydrargyri Subsulphas Flavus (Yellow Mercurial Subsul- 
phate). This salt, commonly called turpeth mineral, from its 
resemblance to the root of Ipomcea turpethum, is made by throw- 
ing mercuric sulphate (as obtained frpm the action of sulphuric 

* "A Treatise on Poisons," 4th ed., p. 427. f Brit. Med. Journ , 1869, -p. 329. 



422 MATERIA MEDICA HEMATICS. 

and nitric acids on mercury) into boiling water; the mercuric 
sulphate is instantly decomposed into a soluble acid, salt and the 
insoluble yellow subsulphate — turpeth mineral — which is precipi- 
tated (Hg(HgO) 2 S0 4 ). It is an inodorous, lemon-yellow powder, 
entirely dissipated by heat, of a rather acrid taste, and sparingly 
soluble in water. It has been employed as an alterative, in doses 
of gr. %-% : as an emetic ; in croup it is highly recommended in 
doses of gr. ij-v in syrup or honey, repeated in fifteen minutes 
if there has not been decided vomiting, and given throughout 
the attack whenever the breathing becomes suffocative from 
accumulations of mucus. It produces free vomiting without 
effort or subsequent depression ; it has been used in chronic 
enlargement of the testis, in the same doses. In an overdose it 
is poisonous,* gr. xl having proved fatal to a man, the chief 
symptoms being violent vomiting and purging. 

Hydrargyri Sulphidum Rubrum {Red Mercurial Sulphide) 
{Mercuric Sulphide) (HgS), or cinnabar (which is found as a 
native combination), is manufactured by subliming a mixture of 
one part of sublimed sulphur and five parts of mercury. It 
occurs in the form of heavy, brilliant, deep-red crystalline 
masses, which are inodorous, tasteless, entirely volatilizable by 
heat, and insoluble in water and alcohol. It is not employed 
internally, but is used in the way of fumigation, in venereal 
ulcers of the throat and nose ; 5ss may be thrown on a red-hot 
iron and inhaled. It is but little used. Cinnabar is used as a 
paint, under the name of vermilion. * 

Unguentum Hydrargyri Nitratis {Ointment of Mercurial 
Nitrate). Mercurial Nitrate is employed chiefly in the form of 
ointment. This preparation, known as citrine ointment, is made 
by dissolving 7 parts of mercury in 10 parts of nitric acid, and 
adding the solution to a mixture of nitric acid 7 parts, with lard- 
oil 76 parts, previously melted at 15 8°, and stirring until effer- 
vescence ceases. The chemical changes which result here are 
not precisely known ; but mercuric nitrate (2(Hg2N0 3 ).H 2 0) is 
probably formed, with fatty acids and ela'idin. Citrine ointment 
has a fine yellow color and an unctuous consistence ; but if not 
very carefully made, it becomes greenish, hard and friable. It is 

* " Med. Jurisprudence," Taylor, 1865, p. 233. 



ALTERATIVES AURIC AND SODIUM CHLORIDE. 423 

an excellent stimulant and alterative application, much employed 
in porrigo, psoriasis, crusta lactea, impetigo, psorophthalmia, and 
a wide range of ulcerated and eruptive affections. It is best to* 
dilute it, at first, with lard. 

Liquor Hydrargyri Nitratis {Solution of Mercurial Nitrate) 
{Mercuric Nitrate) (Hg2N0 3 ) is prepared by dissolving red mer- 
curic oxide (40 parts) in a mixture of nitric acid (45 parts) with 
distilled water (15 parts). It is a dense, transparent, nearly color- 
less liquid (sp. gr. 2.100), of a strongly acid taste, containing 
about 50 per cent, of mercuric nitrate in solution with some free 
nitric acid, and is employed as a caustic application in hospital 
gangrene, venereal and malignant ulcers, and, diluted, in cuta- 
neous affections. A teaspoonful of mercury * dissolved in 
strong nitric acid killed a lad aged sixteen, in two and a half 
hours, with abdominal pain, purging and vomiting. Diluted with 
12 parts of water it forms a useful application to mucous patches. 

AURI ET SODII CHLORIDUM AURIC AND SODIUM CHLORIDE. 

Auric and sodium chloride is a mixture of equal parts of 
these salts (AuCl 3 NaC1.2H 2 0). It is an orange-colored salt, 
without smell but having a nauseous metallic taste. It is soluble 
in alcohol ; more so in water. 

Effects and Uses. — Locally it is a caustic. Internally it is a 
stimulant to the nervous system, especially to the spinal cord. 
It acts like the mercurials on the blood, reducing the oxidizing 
power of the red globules (Farquharson). It stimulates the 
glandular secretion and increases the secretion of urine and of 
perspiration. Salivation, without tendency to ulceration, some- 
times occurs after prolonged use, but is less apt to occur after 
the use of this salt than after the other salts of goldf. In large 
doses it causes violent gastro-enteritis. It stimulates the sexual 
organs and is said to increase the catamenia. Large doses cause 
symptoms analogous to those of poisoning by mercuric chlo- 
ride. The same treatment is indicated. 

This salt is used chiefly as an alterative in chronic cases of 
tertiary syphilis and in scrofula. It is also recommended in 



* London Med. Gazette, VII, p. 339. 

j- Schmidfs Jahrb., June, 1870. Martin. 



424 MATERIA MEDICA HEMATICS. 

nervous dyspepsia, duodenal catarrh, etc. In the chronic forms 
of Bright' s disease, granular and fibroid kidney, improvement 
sometimes follows the use of small doses of this remedy, and in 
functional impotence it is not without value. Dose, gr. -^q - tV- 
It is best given in pill or wafer. 

iodum — IODINE. 

Iodine (I) is an elementary, non-metallic substance, found in 
the vegetable, animal and mineral kingdoms of nature, as in 
marine plants, oysters, sponges, mineral springs, etc. It is 
chiefly manufactured from the residuum of kelp (the impure 
soda obtained from the incineration of sea-weeds), in which it 
exists as a sodium iodide, by the action of sulphuric acid and 
manganese dioxide. It occurs in crystalline scales, of a bluish- 
black color and metallic lustre, of a strong, peculiar odor and a 
hot, acrid taste. It is very volatile, evaporating even at common 
temperatures ; is freely soluble in glycerin, alcohol and ether, 
and but very slightly soluble in water (i part in 7000 parts of 
water). Its solubility in water is very much increased by the 
addition of certain salts, as the potassium iodide, sodium chlo- 
ride, etc. When heated its vapor has a rich violet color, whence 
its name (from l<oty$ 9 violet). Iodine may be detected in very 
minute quantity by decoction of starch, which produces with it 
a combination of a deep-blue color, termed " iodide of starch "; 
if combined, the iodine must be first freed with a little nitric 
acid, or still better with chromic acid. A solution of iodine in 
chloroform should be perfectly clear. 

Physiological Effects. — Iodine is an antiseptic and antizymotic, 
and is a protoplasmic poison, killing the lower forms of animal 
and vegetable life. It acts locally as an irritant ; when applied 
to the skin it stains it yellow, and causes itching, redness and 
desquamation ; and when inhaled in the form of vapor, it causes 
irritation in the air-passages. Internally, in medicinal doses, it 
causes a sensation of heat and burning in the stomach, and soon 
irritates that organ. It is readily absorbed by the mucous 
membranes generally, and is found in the blood chiefly in com- 
bination with sodium ; after absorption it produces a remedial 
alterative effect, without any obvious disturbance of the functions. 
In a physiological condition patients become thin under its use, 



ALTERATIVES IODINE. 425 

though when iodine or the iodides are administered in syphilis, 
their alterative action on the nutrition produces embonpoint, due 
to the elimination of the syphilitic poison which has depressed 
nutrition, and the consequent reaction of the system. It excites 
the secretions generally, increasing the flow of urine, slightly 
relaxing the bowels, often producing a marked irritant effect on 
the respiratory mucous membrane and salivary glands, and is 
readily and rapidly eliminated from the blood, in the urine and 
saliva (See*), and by the mucous membranes generally. If ad- 
ministered in too large doses, or to persons of irritable stomach, it 
produces subacute gastro-enteritis ; and when continued for a 
long time it will produce gastro-enteric symptoms — headache, 
giddiness and other evidences of cerebro-spinal disturbance — 
marasmus — sometimes discoloration of the skin — occasionally 
salivation — and frequently a wasting of the mamma and testicles. 
This train of symptoms is termed iodism. 

In excessive doses it may act as an irritant poison, and has 
even produced death ; but such a result is rare. In the case of 
a woman f 5j in spirit f gj proved fatal, the chief symptoms 
being violent pain in the throat and stomach. Culpeper J reports 
a fatal case of poisoning from the application of a preparation 
of iodine (5ij) to the entire surface of the legs of a child aged 
eleven. The symptoms were vomiting, purging (dysenteric), 
pain in the head and stomach, hiccough, and suppression of 
urine. Large quantities have," however, been taken with slight 
effects (5iiss). The antidote is starch. 

Medicinal Uses. — Iodine has been used with success in some 
cases of vomiting of pregnancy ; a few drops of the tincture 
may be given for this purpose. It is a most valuable resolvent 
remedy in chronic visceral and glandular enlargements, indura- 
tions, thickening of membranes, tumors, etc. It is employed 
chiefly in bronchocele and scrofula ; also as an alterative in the 
late secondary and in the tertiary manifestations of syphilis 
where the iodides are not tolerated, and in other chronic affec- 
tions. It is highly recommended by the Germans in the 



* London Med. Record, 1873, p, 777. 

f Provincial Med. and Surg. Journ., 1847, p. 356. 

% Therap. Gaz., April, 1888, p. 225. 



426 MATERIA MEDICA HEMATICS. 

treatment of typhoid fever, reducing the temperature and 
restraining diarrhoea ; the compound solution or tincture may 
be given, largely diluted. Iodine is highly recommended by 
many observers in malarial fevers, and, while it is admitted 
that it cannot compete with quinine in these diseases, it is 
said that, generally, it promptly arrests the attack.* The com- 
pound tincture should be given in doses of ^x-xv thrice daily 
(Dr. Anderson, quoted by Ringer). The vapor given off by 
volatilizing the tincture by hot water in a wide-mouthed bottle 
has been inhaled with benefit in chronic bronchitis, phthisis, and 
in the coryza of hay fever and influenza. 

It is a valuable topical remedy, and is applied in the form of 
tincture, with the greatest advantage, to enlarged glands (espe- 
cially when scrofulous), erysipelas, boils, carbuncles, to prevent 
pitting in smallpox, as a counter-irritant to the chest in phthisis, 
chronic bronchitis, pleurisy, and in chronic thickenings around 
the joints, due to rheumatism, synovitis or injuries. As a 
counter-irritant, six coats should be applied to the part, morning 
and evening, with a camel's-hair pencil, and each coat allowed to 
become dry before the succeeding one is laid on — to be discon- 
tinued when desquamation occurs. It is more suitable to chronic 
than acute affections. As an injection in hydrocele, it has been 
used with benefit. After the evacuation of the sac, f5ss-j is 
introduced, and the pain may be diminished by the previous 
injection of "Kxx or more of a solution of cocaine (4 per cent.). 
Dr. S. W. Gross f has collected 540 cases of hydrocele treated 
with iodine in which there were no deaths, recurrence in 8.15, 
and suppuration or gangrene in 1.66 per cent. In chronic 
pleurisy with effusion after aspiration, it has even been injected 
into the pleural cavity. In cystic goitre Dr. A. Worner, of 
Tubingen, recommends the injection of pure tincture of iodine 
after puncture and withdrawal of the fluid. It may also be 
used with excellent effect in hypertrophied tonsils and glan- 
dular tumors. The tincture should be deeply injected into 
the part, and care must be taken not to throw the injection 

* Am. Jour n. Med. Sci., April, 1883. Drs. Atkinson and Woods, of Baltimore. 
N. F. Snejkoff (Meditz. Oboz., Fasc. xxin, 1884, p. 1042), obtained no effect 
from iodine in two-thirds of their cases of malarial fevers. 

f Med. Times, April, 1888, p. 384. 



ALTERATIVES IODINE. 427 

into a vessel. Prof. Richet * highly recommended the hypodermic 
injection of the tincture in cases of malignant pustule, and Bev- 
erly Robinson, f following the treatment of Prof. William Pepper, 
has successfully injected from i^v— 1 of Lugol's solution, diluted 
with 15 parts of distilled water, into phthisical cavities. He 
gradually increases the strength of the solution until 25 per cent. 
of its full strength is employed, and finds that in these cases, as 
also when, in the first stage of phthisis, there is consolidation at 
one apex which does not disappear under treatment, or even when 
the consolidated lung begins to soften, that the coughing, dysp- 
noea, expectoration and local soreness, all diminish, that the 
patient gains flesh, and the cavity decreases when present in 
many cases. The injection should be made either high up in the 
axillary region, in the 1st, 2d, or 3d intercostal space, or anteriorly 
in the 1st, 2d, or 3d intercostal space, on or to the outside of the 
line of the nipple. Iodine ranks also among the best of the dis- 
infectants, being available from the ease of its application as well 
as its ready portability. 

Administration. — Iodine is rarely exhibited alone, but usually 
in conjunction with potassium iodide (see p. 428). To avoid 
gastric irritation, it is best given after a meal, particularly when 
amylaceous substances have been taken, as it forms with them 
iodized starch. Dose, gr. Y^-yi two or three times daily. 
Liquor iodi compositiis — compound solution of iodine — sometimes 
known as Lugol's Solution (iodine 5 parts, potassium iodide 10 
parts, distilled water 85 parts), is the usual preparation in which 
iodine is administered internally; dose, f^v-xv three times a 
day, in sweetened water and gradually increased. The tincture 
{tinctura iodi) (8 parts to alcohol 92 parts) is of a deep-brown 
color, and undergoes a gradual change when kept long ; water 
precipitates the iodine from it, hence it is little employed inter- 
nally ; dose, gtt. x-xx, repeated and increased. Externally it is 
extensively applied to erysipelatous and poisoned parts, chilblains, 
and parasitic affections. Stains of the tincture may be removed 
from the skin by aq. ammoniae ; from linen by sodium hyposul- 
phite in solution. The compound tincture (iodine Sss, potassium 
iodide oj, alcohol Oj is not officinal, but has the advantage over 

* Rev. des Sc. Med., Avril 2iiem e> 1883. f N. Y. Med. Rec, Jan. ioth, 1885. 



428 MATERIA MEDICA HEMATICS. 

the tincture that it may be diluted with water without decom- 
position ; dose, gtt. xv-xxx. Iodine ointment (tingitentum iodi) 
(made with iodine 4 parts, potassium iodide 1 part, water 2 parts, 
and benzoinated lard 93 parts) is employed as a local application 
in goitre, scrofulous tumefactions, etc. Iodine baths have been 
employed, with iodine and potassium iodide dissolved in water, 
in a wooden bath-tub, in the proportion of iodine gr. iij and 
potassium iodide gr. vj to a gallon of water. 

POTASSII IODIDUM POTASSIUM IODIDE. 

This salt is prepared by treating an aqueous solution of potassa 
with iodine in slight excess. By this process a mixture of potas- 
sium iodide and potassium iodate is obtained, and the iodide is 
afterward deoxidized and converted into iodide by heat and mix- 
ture with powdered charcoal. Potassium iodide (KI) occurs in 
semi-opaque, white or transparent anhydrous crystals, permanent 
in a dry air, rather deliquescent in a moist one, of an acrid, saline 
taste, somewhat like that of common salt. It is wholly soluble 
in water and alcohol, and its aqueous solution dissolves iodine, 
forming io dure tied potassium iodide. It is frequently adulterated 
with other salts. It is incompatible with acids and acid salts, 
spt. nitrous ether, soluble lead salts and the mercurials generally ; 
with potassium chlorate, if a mineral acid be added, a poisonous 
potassium iodate is produced. 

Effects and Uses. — The effects of potassium iodide are analo- 
gous to those of iodine, but less energetic. Locally, it acts as 
an irritant. Internally in large doses it sometimes occasions 
nausea, vomiting, heat of stomach, and purging ; but it may be 
given in larger doses, and for a longer period, than iodine without 
causing gastro-enteric derangement. Pelikan in 1856 denied that 
the iodides of the alkalies irritate the gastro- intestinal mucous 
membrane, and this is also affirmed recently by Dr. A. Smirnoff 
(loc. cit). Under its prolonged use, the digestive function of the 
gastric juice fails, although the quantity secreted remains unal- 
tered (A. Smirnoff*). It stimulates the secretions, particularly 
those from mucous membranes, and very often produces coryza. 
Potassium iodide decidedly lessens the secretion of milk, and as 

* " Inaug. Dissertation," St. Petersburg, 1884. 



ALTERATIVES POTASSIUM IODIDE. 429 

it disturbs the function of the glands the relative quantity of the 
different ingredients fluctuates. Iodine appears in the milk very 
soon after the first dose of the salt is taken, and disappears as 
soon as the drug is stopped. It is found in combination with 
the casein of the milk, but the amount present bears no constant 
relation to the amount of the salt administered (Dr. Max StumpP). 
It is eliminated by the mucous membranes generally, but chiefly 
by the kidneys acting as a diuretic and increasing the amount 
of water, urea, uric, phosphoric and sulphuric acids in the urine. 
Its constitutional effects are powerfully alterative and resolvent, 
as it increases the disintegration and elimination of albuminous 
compounds, thus causing wasting and emaciation when admin- 
istered in health ; but like iodine, it acts most readily on morbid 
products. 

It is employed in bronchocele and scrofula ; in tertiary .syphilis 
(in which it is usually combined with or followed by some 
mercurial preparation), and other chronic diseases, accom- 
panied with enlargements or indurations. It is a most valuable 
antisyphilitic remedy when the bones and fibrous tissues 
are affected. In all nervous affections of syphilitic origin, as 
syphilitic neuralgia or paraplegia, large doses of the salt give 
prompt relief, and in gummata of the brain they are of signal 
advantage. It has been given hypodermically when it disorders 
the digestion. In chronic rheumatism and gout, particularly 
where the fibrous tissues are attacked, it is of great efficacy. It 
is highly recommended in the early stages of interstitial hepatitis 
(cirrhosis) before contraction has taken place. As a diuretic 
in serous effusions it has been found useful ; and in spasmodic 
asthma, given between the attacks, it will often prevent their 
occurrence or increase the interval between them. As an elimi- 
native antidote in mercurial and saturine poisoning its action has 
been already noticed. It has been recommended in hydro- 
cephalus ; and has been found to exercise a beneficial operation 
in the treatment of aneurism. In deep-seated aneurism, large 
doses (gr. xx-xl) are advised by Burney Yeo,fwho thinks these 
exert a favorable influence by diminishing cardiac action and 

* Deutsche* Arch. f. klin. Med., Jan., 1882. f Lancet, Feb., 1886. 



430 MATERIA MEDICA HEMATICS. 

lowering the general blood-pressure. Dr. H. W. Stelwagon* 
recommends it highly in subacute and chronic eczema, espe- 
cially when arsenic has failed to exert a favorable influence on 
the disease, combined with suitable external treatment. He 
gives gr. ss increased to gr. v to a child in syrup of orange-peel 
and water, or to an adult, gr. v-x in Huxham's tincture or com- 
pound tincture of gentian. 

Administration. — Dose, gr. v-xv to 5j or more (depending on 
the idiosyncrasy of the patient), three times a day, in solution, 
but very much larger doses may be required in tertiary syphilis. 
Mr. Jonathan Hutchinsonf recommends beginning with a small 
dose (gr. ij-iij) at first, increased by the addition of gr. ij per 
week, if the cure be not progressing rapidly. He finds a com- 
bination of ammonium, sodium and potassium iodides often 
answers better than the potassium salt alone, and that free am- 
monia or sal volatile increases the efficiency of any of the iodides. 
The compound syrup of sarsaparilla is one of the best vehicles 
to disguise its unpleasant taste. An ointment (12 parts, sodium 
hyposulphite 1 part, benzoinated lard 81 parts, boiling water 6 
parts), is employed for the same purpose as iodine ointment, and 
does not discolor the skin ; it is, however, of feebler efficacy. It 
is said that when administered in milk, not only is the unpleas- 
ant taste somewhat disguised, but the salt is less apt to disagree 
with the stomach. 

Ammonii Iodidum — Ammonium Iodide (NH 4 I) — is made by 
the double decomposition of potassium iodide and ammonium 
sulphate in hot aqueo-alcoholic solution. It occurs as a white, 
granular, very deliquescent salt, becoming yellowish-brown by 
exposure, but when deeply colored, the U. S. P. directs that " it 
should not be dispensed." It is very soluble in water and alco- 
hol, of a taste like that of potassium iodide, but a little sharper. 
It has been similarly used as the latter salt, and recommended 
in catarrhal jaundice after the acute symptoms have subsided 
(gr. j-iij p. r. n.), and in the early stages of cirrhosis of the liver. 
It is also very useful in chronic bronchitis, capillary bronchitis 
and in pneumonia, to promote the absorption of the exudation 
and to prevent caseous degeneration. 

* Med. News, April 2d, 1885. f " On Syphilis," 1887. 



ALTERATIVES IODOFORM. 43 I 

Sodii Iodidum — Sodium Iodide (Nal) — may be made by 
the double decomposition of iron iodide and sodium carbonate. 
It is a soluble, white, crystalline salt, used to fulfill the same indi- 
cations as potassium iodide, than which it is said to be better 
borne. 

Iodine is employed in medicine in various chemical combina- 
tions. The iron, lead and mercurial iodides have been noticed. 
Iodized starch (amylum iodidum) has been highly recommended 
as a dressing for syphilitic ulcers, etc. Zinc iodide (see p. 198) 
is employed as a tonic and astringent. Sulphur iodide {sulphuris 
iodidum) is prepared by heating together iodine 4 parts, and 
washed sulphur 1 part ; it is a grayish-black solid substance, of 
a radiated crystalline appearance, having the smell and taste of 
iodine, decomposed upon exposure to the air and by boiling 
water and alcohol, insoluble in water, but soluble in 60 parts of 
glycerin ; it is used internally in scrofulous and cutaneous 
affections, in doses of gr. }4~), and externally in tinea capitis, 
lupus, lepra, acne, etc., in the form of ointment (gr. xxx to 
lard Sj). 

IODOFORMUM IODOFORM. 

Iodoform is obtained by the action of chlorinated lime upon 
a heated alcoholic solution of potassium iodide, which yields 
calcium iodate and iodoform, the latter being separated by the 
solvent action of boiling alcohol. It is formyl teriodide (CHI 3 ), 
and occurs in the form of small, scaly, yellow crystals, having a 
saffron-like odor and sweet taste, insoluble in water, but solu- 
ble in alcohol, ether, chloroform, and the fixed and volatile 
oils. 

Physiological Effects. — According to Dr. G. Rommo* Mikhail 
P. Pohakoff and others, the effects of iodoform internally are as 
follows : Nervous system ; in warm-blooded animals, iodoform 
at first lowers the functional activity of the nerve-centres ; 
voluntary motion is next affected and finally abolished (espe- 
cially in frogs) ; anaesthesia is present to some extent, and the 
reflex functions of the cord are depressed ; the excitability 
of the nerve-trunks to external stimulation is lessened, as is also 
muscular contractility. A period ensues if a sufficiently large 

* Arch, de Physiol., 1883. 



432 MATERIA MEDIC A HEMATICS. 

dose has been taken during which there is excitation of the 
nerve-centres, with clonic and tonic contractions of the muscles. 
Circulation : the capillaries in the web of the frog's foot at first 
dilate but afterward contract. In mammals, a moderate dose 
primarily retards and strengthens the pulse, while slightly eleva- 
ting the arterial pressure from stimulation of the cardio-inhibitory 
centre : under full doses, the pulse becomes markedly slower and 
feebler, and the blood-pressure falls. Larger doses at first cause 
slowing of the pulse, which, however, soon becomes quick and 
irregular, from paralysis of the cardiac centre, but this is soon 
followed by secondary retardation and final arrest in diastole, 
from paralysis of the cardiac muscle. Respiration and tempera- 
ture : moderate doses cause a rise in the temperature from 
1.8° to 2. 7° (in dogs); larger doses produce a marked fall 
of temperature (7. 2° to g° F.) and convulsive respiratory 
movements. Gastro-intestinal tract : full doses cause vomiting 
and diarrhoea (in dogs). Secretion : it increases the salivary, 
biliary, and intestinal secretion. Elimination : it is eliminated 
unchanged in small quantities by the lungs, but principally 
leaves the system as alkaline sodium iodate, in the urine, which 
may be found one hour after iodoform has been administered 
and may be present for three days. When an excessive dose 
has been taken, elimination is checked, albumen and blood 
appear in the urine, glomerulo-nephritis and fatty degeneration 
of the liver, heart and other organs occur, and an inflammation 
of the spinal cord, with results similar to acute polio-myelitis, is 
found. According to Schede and to Kuster the symptoms of 
poisoning may be divided into six classes: 1. In this class of 
cases high fever is the only symptom. 2. Fever with gastro- 
intestinal irritation, rapid pulse, and depressed spirits ; recovery 
is the rule. 3. Very rapid, compressible pulse, but no fever ; a 
very dangerous form. 4. Very rapid pulse and very high fever ; 
few recover. 5. Great depression, collapse, and death; seen espe- 
cially after severe operations. 6. Cerebral symptoms, resembling 
meningitis. 

The best preventive to poisoning by iodoform consists in 
remembering that its absorption, even when used externally, is 
much more rapid than its elimination. Should poisoning occur, 
withdraw every particle of the adherent dressing, sustain the 



ALTERATIVES IODOFORM. 433 

system with stimulants and opium, and give large doses of 
potassium bicarbonate (Behring*). Topically it is a germicide, 
and local anaesthetic. 

Medicinal Uses. — Bozzolo, following Moleschott, recommends 
it highly in glycosuria. He finds that the elimination of sugar 
and the amount of urine are diminished and the blood-pressure 
lowered by the daily use of gr. xv-xxx (i Gm. to 2 Gm.). From 
its action on the circulation it is recommended by Moleschott, 
Testa, and others, in valvular diseases where the hypertrophy is 
not compensatory. In these affections, given in doses of 
gr. y^, five or six times a day, it lessens the dyspncea, and cedema 
and increases the urine, the heart beats more regularly, and the 
tendency to hemoptysis disappears. Numerous observers speak 
highly of its use in phthisis as increasing the body weight and 
appetite, diminishing the cough, expectoration, and night-sweats 
and slightly lowering the temperature. It is of more value in 
the early than in the later stages of this disease. As an anthel- 
mintic, it has been used for the destruction of taenia and of 
ascarides, but observers differ as to its value in these affections. 
It has also been used internally in syphilitic rheumatism and 
various neuralgic affections, and Dr. Thomann has employed it 
with advantage, suspended in glycerin, as a hypodermic injection 
in recent syphilis with skin manifestations and lymphatic involve- 
ment. Dose, gr. j-iij, three times a day, in pill, but much larger 
doses have been given without producing untoward effect. In the 
form of vapor it is said to possess anaesthetic properties, inferior, 
however, to those of chloroform. Externally it is a local anaes- 
thetic, and has been found a good application to chancres and 
irritable ulcers, as bed-sores ; it is used also to relieve the pain 
of cancers, and for these purposes it may be dusted over the 
ulcerated surface, which is then to be dressed with glycerin spread 
upon lint, and may be powdered over the surface of foul-smelling 
ulcers, to allay their odor. A saturated solution of iodoform in 
chloroform is serviceable in relieving the pain of neuralgia and 
gout ; an iodoform suppository is also useful in painful diseases 
of the rectum and bladder. Altschul recommends iodoform as 
the most efficacious application for burns of the second and third 



* Deutsche Med. Wochensck., Jan., 1883. 
28 



434 MATERIA MEDICA HEMATICS. 

degree ; he prefers either an iodoform-gelatin of the strength of 
io per cent., or better still, an iodoform paste prepared as follows : 
3^ White wax, 5ss ; olei olivse, f 5j ; liquoris plumbi subacetatis, 
f 5iv ; iodoform, oij-iv. M. As an antiseptic, Mikulicz * found 
iodoform to be equal to carbolic acid, and less apt to produce 
constitutional disturbance from absorption. As a dressing to 
open wounds he found it would check profuse discharge, pre- 
vent decomposition, and stimulate healthy granulations. In 
treating deep wounds he recommends a pencil composed of 
iodoform, i part, with oil of theobroma, 2 parts. The smell can 
be overcome by adding oil of bergamot, ^j, to iodoform gr. x. 
In septic, gangrenous, or sloughing wounds it forms an excel- 
lent dressing, and is very useful in chronic or irritable leg- 
ulcers. Rommo [pp. cit) found it more efficacious in preventing 
the appearance of bacteria than in arresting their multiplication. 
In strumous diseases it is almost a specific. Burman speaks 
highly of a solution of iodoform, §j, to collodion, f§x, painted 
well beyond the line of redness in erysipelas ; and Dr. Tschalo- 
voski has seen excellent results follow the application of the 
powder to smallpox pustules, during the stage of suppuration, 
to prevent pitting. In purulent inflammation of the cornea, in the 
membranous forms of conjunctivitis, and as an antiseptic in 
ophthalmic surgery, the pure drug, finely powdered, is highly 
recommended. Bougies made with iodoform in glycerin and 
gum-acacia, have been passed into the uterine cavity (previously 
washed out with carbolized water) of puerperal women and 
allowed to dissolve, when septicaemia was feared ; and it has been 
used as an injection in acute gonorrhoea in the proportion of 3v 
to carbolic acid, gr. jss, glycerin, foiiss, and water, f§ss. Only one 
injection should be used per diem for three or four days, after 
which it may be used twice daily. The oi?ttment consists of 
iodoform, io parts, rubbed up with benzoinated lard, go parts. 

IODOL. 

Iodol (not officinal) obtained by the action of iodine on 
certain constituents of animal oilsf, is chemically tetra-iodo- 
pyrol (C4I4NH). It is a " light-yellowish-gray, fine and specific- 

* Wiener Med. Wochenschrift> 1881. f Lancet, Nov., 1885, p. 1013. 



ALTERATIVES — IODOFORM. 435 

ally light powder," soluble in 5000 parts of water in 3 parts of 
alcohol, and in about its own weight of ether. The addition 
of water to the alcoholic solution causes a milky precipitate*. 
It is very rich in iodine, containing 88.9 per cent. It has very 
little taste, and is free from disagreeable odor. When in con- 
tact with the tissues and secretions of the body iodine is readily 
liberated, but no constitutional phenomena have attended its 
long-continued use as an external applicationf. It is slightly 
caustic, adhering readily and uniformly to the surface of a wound, 
and forming a gray protective film to the granulations underneath. 
It is said to aid the process of cicatrizationj. Its antiseptic power, 
which is due to the liberation of iodine, is about equal to that of 
iodoform, -to which it is preferable from its comparative freedom 
from nauseous smell and taste and the absence of toxic symptoms 
attending its external use. Whether used locally, or adminis- 
tered internally, its presence can shortly be detected in the saliva 
and urine. 

As an external application it has been extensively used in the 
treatment of chancres, buboes, and also in simple indolent ulcers 
with good results, and in no case was there any erysipelatous or 
diphtheritic inflammation observed. Dr. Petersen, of St. Peters- 
burg, however, applying it as a dusting powder to chancroids 
three or four times daily, observed that usually about the third 
day the granulations became flabby, "as if hyaline," and the 
granulation-process was retarded. Iodol has been much lauded 
as a substitute for iodoform in ophthalmic practice, % particularly 
in the chronic forms of conjunctivitis and in sluggish corneal 
ulcers, || but is contra-indicated in affections of acute irritative 
character. According to Katzaiiroff, iodol always caused much 
more irritation than iodoform, when the powder was applied to a 
healthy eye, and did not prove as useful in his hands, except 
in phlyctenular conjunctivitis, trachoma and opacities of the 
cornea, in which it was of great service. 



* Merck's Bulletin, June, 1888, p. 17. 
f Practitioner, May, 1887, p. 336. R. N. Wolfenden. 
% Bull. Gen. de Therap., Fev., 1887. Dr. Juquer. 
\ Centralbl. fiir Bract. Augenheilk.,]&x\., 1886. Glassner. 

|| V Union Mid., Mars 22d, 1886; Annates d' Oculist, Mai, Juin, Juillet et Aout, 
:886. Dr. Trousseau. 



436 MATERIA MEDICA HEMATICS. 

In nasal, laryngeal and pharyngeal affections it is highly recom- 
mended, particularly in laryngeal phthisis, in which it is often 
of signal value (R. N. Wolfenden). Internally, it has been used 
as a substitute for iodoform. Dose, gr. %-\], in capsule, pill or 
solution. Locally to the eye or throat, it is used in powder or in 
alcoholic solution diluted with glycerin (iodol I part, alcohol 16 
parts, glycerin 34 parts), and to wounds in powder, solution, 
ointment (1 or 2 per cent), bougies, wool or gauze. 

OLEUM MORRHILE COD-LIVER OIL. 

This is a fixed oil obtained from the liver of Gadus Mor- 
rhua, the common cod {Class Pisces ; Ord. Teleostia, Fam. Gadida) 
— a well-known fish of the northern Atlantic — and also from the 
livers of several other species of Gadus. It is prepared by sub- 
jecting the livers to heat, either in boilers with water or by means 
of steam externally applied, and afterward draining off* the liquid 
portion, from which the oil separates on standing. It is said to 
be sometimes procured also by expression. Three varieties are 
known, the white or pale-yellow ', the brownish-yellow , and the dark- 
brown. They differ chiefly in the mode of preparation — the pale 
being prepared from fresh livers, the dark-brown from those 
which are collected at sea and have undergone putrefactive 
decomposition, and the brownish-yellow from those in which 
putrefaction has only partially commenced. The pale oil is the 
purest ; the dark oil is the most offensive to the taste and smell, 
and the least acceptable to the stomach. 

Cod-liver oil'is of the consistence of lamp-oil, and has a pecu- 
liar odor, resembling that of shoe-leather — which is usually pre- 
pared in the United States with this oil — and a fishy-acrid taste. 
These sensible properties are probably ' the best tests of the 
genuineness of the oil, and jt should be rejected if the smell and 
taste of shoe-leather are wanting, or if those of lamp-oil or fish- 
oil are very perceptible. The sp. gr. of the best oil is about 
0.920—0.925. The oil undergoes a gradual change from exposure 
to the air, and should, therefore, be kept in full and well-stop- 
pered bottles. It is insoluble in glycerin and water, somewhat 
so in alcohol, readily soluble in ether and chloroform. It con- 
tains a great variety of chemical constitneitts, the most important 
of which are fatty acids, several biliary principles, a peculiar brown 



ALTERATIVES COD-LIVER OIL. 437 

substance called gaduin (which is not, however, supposed to be 
the active ingredient), iodine, chlorine and traces of bromine. 

Dr. Joseph Lefage,* assisted by Dr. Chapoteaut, obtained 
a product from the oil which they named morrhuol, and which 
represents the active principles of cod-liver oil. 

It is obtained (i) by treating the oil with an aqueous solution 
of sodium bicarbonate, which dissolves the acid at low tempera- 
ture ; (2) by agitating the oil with 90 per cent, of alcohol, sepa- 
rating it from the oil and submitting it (alcohol) to distillation. 
Morrhuol is acrid, bitter, very aromatic and partly crystalline at 
ordinary temperatures. It contains considerable quantities of 
iodine, bromine and phosphorus. The oil after its removal is 
tasteless and odorless. 

Cod-liver oil may be distinguished from other oils by the 
agency of sulphuric acid, a drop of which, when added to fresh 
cod-liver oil, on a porcelain plate, causes a centrifugal movement 
in the oil, and gives rise to a fine violet color, soon passing into 
yellowish or brownish-red. This reaction is attributable, how- 
ever, to the bile contained in the oil. By reaction with ammonia, 
in distillation, the peculiar volatile principle trimethylamine (the 
odorous principle of pickled herring) is developed. 

Physiological Effects. — Cod-liver oil, like all fats, is appropriated 
in the small intestine, and not in the stomach. Its prolonged 
use, in doses which allow it to be retained by the digestive tube, 
produces very marked beneficial effects in a wide range of chronic 
diseases, dependent on a vitiated condition of the functions of 
digestion, assimilation and nutrition. Its modus medendi is not 
well understood, some therapeutists believing it to act merely 
as a nutritive agent, valuable from the readiness with which it is 
assimilated ; others attributing its curative powers to an altera- 
tive action from the iodine and bromine or other principles which 
it contains. Its effects are, however, probably due merely to its 
nutrient action, in supplying a sufficiency of molecular base for 
interstitial growth. The biliary principles which it contains pro- 
mote its absorption and appropriation by the system. The most 
striking feature of its action on the economy is increase of weight; 
and usually, where it fails to increase the weight, it is of little 

* Der Fortschritt, Feb. 20th, 1886, from Le Bull, de Therap. and Le Bull.. Com. 



43 8 MATERIA MEDICA HEMATICS. 

service. It is believed, also, to diminish the formation of uric 
acid in the system, and hence may be useful in gout. In large 
doses, cod-liver oil produces nausea and diarrhoea, and these 
effects occasionally follow the use of medicinal doses. 

Medicinal Uses. — Cod-liver oil has long been known as a 
remedy in rheumatic diseases ; and within the last forty years it 
has come into extensive use as an alterative in tuberculous and 
scrofulous affections. In the treatment of phthisis pulmonalis it 
is now looked upon, in Great Britain and the United States, as 
superior to any other agent, and as possessing an undoubted 
power of arresting the progress of both the general and the 
local symptoms of the disease. Although efficacious in all the 
stages of phthisis, its value is most conspicuous early in the 
disease, especially before the formation of true tubercles. 

Morrhuol is strongly recommended in the first stage of tuber- 
culosis, in infantile scrofulosis and rachitis, and in chronic bron- 
chitis.* Dr. E. Chazeaud,f from the careful study of ten cases of 
pulmonary phthisis in which he had administered morrhuol, 
concludes that it increases the appetite and weight, lessens or 
extinguishes the cough and with it the symptoms of debility, 
and diminishes the excretion of urea. 

Over the different forms of scrofula it exercises also a very 
decided control — particularly glandular enlargements, ulcers, 
diseases of the joints and spine, ophthalmia, etc. In the various 
cutaneous affections, tertiary syphilis, chronic rheumatism and 
gout, and the entire circle of chronic disorders in which there is a 
tendency to marasmus, and where the nutrition is defective, cod- 
liver oil is employed with benefit. Its good effects are most con- 
spicuous in proportion to the youth of the patient. 

Admiiiistration. — Dose, fSss two or three times a day, one 
hour after each meal; though, if unacceptable to the stomach, 
it is best to begin with f5j doses. The addition of a little 
ether (gtt. xij-xx to f5j of oil) promotes its digestion. It 
must be persevered with for a long time before its good effects 
appear. It is best given in some aromatic water, or a little 
ardent spirit, or the froth of porter ; and it may be rendered 



* Dr. Joseph Lefage, op. cit. 

f Etudes cliniques sur le morrhuol, these, par E. Chazeaud, Paris, 1887. 



ALTERATIVES PREPARATIONS OF ARSENIC. 439 

more agreeable to the stomach by combination with one of 
the mineral acids. The union of the oil with lime-water, just 
enough to form a soap, often renders it acceptable to delicate 
stomachs, and it may be flavored with oil of bitter almond. If 
it produce diarrhoea, astringents should be administered with it, 
or the dose should be decreased, or the oil stopped. It is used 
as a clyster in cases of ascarides and lumbricoides ; and externally, 
in cutaneous affections and opacity of the cornea. 

Phosphorated cod-liver oil is made by the direct addition of 
phosphorated oil (see p. 178) to the amount of cod-liver oil 
required to furnish the desired strength of phosphorus. 

Morrhuol is best given in capsules (gr. iij = gr. 80 of the oil) 
on account of its disagreeable taste and aromatic smell. 

ARSENII PR^PARATA PREPARATIONS OF ARSENIC. 

Metallic arsenic is inert, though when swallowed it may prove 
powerfully poisonous by becoming oxidized and converted into 
arsenious acid. It is not used in medicine. 

Acidum Arseniosum (Arsenious Acid)(As 2 3 ), sometimes called 
white arsenic, arsenic oxide or arsenic, is obtained principally as a 
secondary product in the roasting of cobalt ores (the cobalt 
arsenides) in Saxony and Bohemia. It is afterward purified by 
sublimation, and when recently prepared, occurs in glassy, color- 
less, transparent masses of a vitreous fracture, which gradually 
become white and opaque, progressively from the surface in- 
ward. It is kept sometimes in the shops in the form of a fine 
white powder ; but in this state it is liable to adulteration with 
chalk or calcium sulphate, and it should, therefore, be always 
purchased in masses. It is entirely volatilized by heat, at a tem- 
perature not exceeding 424.4 F. ; has no smell and little or no 
taste; is soluble in water, and also in alcohol and oils. Cold 
water dissolves from yoVo tn to 3-5-5-th P art of its weight of 
arsenious acid, or about gr. ss-j to f Sj. If boiled for a short 
time with water, about -^-th part will be dissolved ; if boiled for 
an hour, yg-th part will be dissolved, or about gr. xij to f Sj.* 

Tests. — Owing to the frequent use of arsenious acid as a 



* " Med. Jurisprudence and Toxicology," 1884, p. 239, Reese; and Taylor's 
" Med. Jurisprudence," 7th Am. ed., p. 140. 



440 MATERIA MEDICA HEMATICS. 

poison, a knowledge of the means of detecting its presence is 
of great importance. In the solid state it may be recognized in 
the first place by its volatility (heated over a spirit-lamp, it passes 
off as a white, inodorous vapor, and is deposited on a cool sur- 
face as an amorphous powder or in octahedral crystals) : secondly, 
when thrown on burning charcoal it is deoxidized, and gives out 
the garlicky odor of metallic arsenic (other substances give off a 
similar odor) ; and thirdly, if heated in a glass tube with char- 
coal or black flux, it sublimes and condenses in the form of a 
brilliant steel-gray ring or mirror, soluble in sodium or calcium 
hypochlorite. In aqueous solution arsenious acid may be detected 
by the following reagents : sulphuretted hydrogen or ammonium 
sulphide produces a lemon or sulphur-yellow arsenic trisulphide, 
which may be distinguished from antimonial and stannic sul- 
phides by being soluble in a solution of ammonium carbonate 
and insoluble in diluted hydrochloric acid ; the addition first of 
ammonia and then of silver 7iitrate produces a canary-yellow silver 
arsenite ; and the addition of ammonia and then of cupric sul- 
phate produces an apple or grass-green cupric arsenite; gr. ioo 
boiled with diluted hydrochloric acid, and then treated with 
sulphuretted hydrogen, yield a deposit of arsenic trisulphide 
weighing gr. 124. The arsenic trisulphide may be r^^^ and 
made to yield metallic arsenic, if heated with soda flux or 
potash flux. 

A very delicate test of arsenious acid in solution is that of 
nascent hydrogen termed Marsh's test. When the acid is sub- 
mitted to the action of nascent hydrogen (evolved by the action 
of diluted sulphuric acid on pure zinc), it is deoxidized, and 
unites with the hydrogen to form arseniuretted hydrogen gas. 
This gas has a garlicky odor, and is recognized by its burning 
with a bluish-white flame which deposits on a plate of cold glass 
or porcelain, held over the jet, a lustrous steel-gray or brownish- 
black spot or mirror of metallic arsenic, surrounded by a faint 
white ring of arsenious acid ; the metallic spot deposited is dis- 
tinguishable from antimony, obtained by a similar process, by 
the addition of a drop or two of fuming nitric acid, with heat, 
which dissolves both metals, the solutions yielding on evaporation 
white residues, but the arsenical residue, touched with a drop of 
strong solution of silver nitrate, assumes a brick-red color, while 



ALTERATIVES PREPARATIONS OF ARSENIC. 44 1 

the antimonial residue remains unchanged ; and also the arsenic 
can be dissolved by a solution of sodium or calcium hypochlo- 
rite, which does not affect antimony. 

Another test is that of Reinsch, and consists in boiling a solu- 
tion of the acid with hydrochloric acid and copper foil or wire, 
when the latter acquires a steel-gray coating of metallic arsenic, 
passing, as it increases, into black. Other metals, as mercury 
and antimony, are deposited on copper under similar treatment, 
so that additional tests will have to be made to prove their 
absence. 

The Berzelius- Marsh test consists in the decomposition of 
arseniuretted hydrogen gas in the reduction tube (of a Marsh- 
apparatus) by heat, with the production of a metallic deposit 
before the flame is reached. It is now considered to be the most 
delicate of all tests. 

When arsenious acid is dissolved with liquid organic substances, 
it should first be separated from insoluble matters by filtration, 
and the metallic arsenic may be then obtained by Reinsch 1 s pro- 
cess, and the liquid or subliming tests afterward applied. If the 
poison be mixed with solid organic substances, they should be 
cut up and boiled with water acidulated with hydrochloric acid, 
and the solution afterward filtered and again boiled, etc. 

Physiological Effects. — Arsenious acid acts locally as an escha- 
rotic by destroying the vitality of the parts to which it is applied. 
In medicinal doses it stimulates the digestive and nutritive func- 
tions, as is shown by the well-known results of arsenic-eating 
among the peasantry of Austria. Ringer and Murrell's* experi- 
ments upon frogs show that arsenic is poisonous to all nitro- 
genous tissues, but that it takes some time for it to destroy the 
conductivity of the motor nerves and the muscular irritability. 
Their experiments differ from those of Sklarekf in respect to 
sensation and reflex action, for they found that the afferent 
nerves retained their conducting power, while Sklarek states that 
sensation and reflex action are abolished in ten minutes. The 
paralysis finally produced by arsenic is centric, with which state- 
ment all observers agree. Its physiological effects are not, at 

* Journ. of Physiol., 1878-9, p. 213. 

f Arch, fur Anat. u. Physiol., 1 866, p. 481. 



44 2 MATERIA MEDICA HEMATICS. 

first, very obvious. When continued for some time, it generally 
produces more or less heat and dryness of the throat and stom- 
ach, with nausea, increased secretion from the bowels and kid- 
neys, irritation of the conjunctival and nasal mucous membranes, 
and a peculiar swelling of the face termed oedema arsenicalis ; after 
the latter symptom appears, the medicine should be suspended. 
No matter how administered, or by what channel it enters the 
system, arsenic shows a marked selective affinity for the gastro- 
intestinal and mucous tracts. Injected into the blood in mammals 
it causes enormous sinking of the blood pressure with slowing of 
the pulse rate (Unterberger*). Small doses increases the cardiac 
action and the activity of the capillary circulation ; large doses 
cause palpitation, a small, quick and irregular pulse, with flushed 
face and cold extremities ; poisonous doses depress the circula- 
tion and (in the lower animals) paralyze the heart in diastole. 
Arsenic, if too long continued or given in an excessive dose, 
decreases the number of globules in the blood, decomposes the 
hemoglobin and renders it less coagulable (Brodie, quoted by 
Phillips). Small doses stimulate, while larger doses depress, 
both the respiratory centre and the pulmonary end-organs of the 
pneumogastric. At first the urine is increased, but if the drug be 
continued it is diminished, and may be bloody or albuminous 
(Kosself). In too long-continued or too large medicinal doses, arseni- 
ous acid sometimes produces a sort of chronic poisoning, char- 
acterized by disorders of the digestive apparatus, conjunctivitis, 
oedema of the face, but more especially of the eyelids, salivation, 
a cutaneous eruption, loss of the hair and nails, paralysis, convul- 
sions, and, if its use be persevered in, coma and delirium may 
result, terminating in death. 

In excessive doses arsenious acid is a violent poison, usually 
destroying life by gastro-enteritis, in from one to two or three 
days. Three fatal cases of arsenical poisoning have, however, been 
recently reported, in which no gastro-intestinal inflammation was 
found (J. Stewart J). When very large quantities are taken, it 
sometimes acts on the cerebro-spinal system, producing death 



* Arch, fur exper. Pathol, u. Pharmakol., II, p. 89. 

f Arch, fur exper. Pathol, u. Pharmak., 1878-9, p. 213. 

% Med. News, March 17th, 1888, p. 304. 



ALTERATIVES PREPARATIONS OF ARSENIC. 443 

by narcotism in a few hours. Occasionally gastro-enteric and 
cerebro-spinal symptoms both occur. Pain and diarrhoea are not 
infrequently absent, as in the cases reported by Taylor (loc. cit!). 

Two grains of arsenious acid have proved fatal, though 
much larger amounts have been taken with impunity, as in the 
case of a woman * who swallowed 5ij, and who recovered after 
being vomited with tartarized antimomy. Very large quantities 
often cause emesis, which removes the poison from the stomach. 
M. Brouardelf records a case of death of a nursing infant, fol- 
lowing symptoms of arsenical poisoning in its wet nurse, who, 
however, recovered. He considers it dangerous to administer 
arsenic to wet nurses, as the lacteal secretion is active in elimi- 
nating it. 

Dissections in cases of poisoning from this agent reveal red- 
ness (sometimes accompanied with extravasations of blood), 
ulceration, softening, effusion of lymph, and even gangrene, in 
the alimentary canal. Congestions of the broncho-pulmonary 
mucous membrane and of the lungs themselves are often 
observed, and acute fatty degeneration of the liver, spleen, kid- 
neys, etc., is often seen, even when the poisoning has existed for 
a few hours only. The blood is often fluid and dark-colored. 

The absorptionj of arsenious acid into the system, after its 
administration, is shown by its presence in the blood, viscera, 
bile, urine, sweat, the buccal, bronchial and intestinal mucous 
membranes, and, after the ingestion of large doses, a considerable 
amount is found in the liver (Lolliot§). According to Rabuteau||, 
arsenic diminishes the excretion of urea, but other observers 
have not confirmed this statement. It is rapidly eliminated by 
the urine, and also by the bile, and even the skin, tears and 
saliva. The milk of nursing women to whom it has been admin- 
istered also contains arsenic (Brouardel ; Pouchet). After it has 
ceased to appear in the excretions, the administration of potas- 
sium iodide will cause it to reappear, showing that a part of it 
remains deposited in the tissues. Recently arsenic has been 
found to be deposited in the nervous system : thus, if in fresh 

* Guy's Hosp. Rep., 185 1, p. 203 ; Taylor. 

f'Societe de Med. Legale," 1885. 

%Arch. Gen. de Med.,t. iv, 6ieme Ser., p. 173; Bergeon et Lemaitre. 

I Bull. Gen. de Therap., LXXV, p. 358. || Gaz. Hebdom., V, p. 705. 



444 MATERIA MEDICA HEMATICS. 

muscle I part is found, the proportion in liver is 10.8; in brain, 
36.5 ; in the spinal cord, 37.3 (Scolosuboff *). Experiments have 
proved that arsenic in solution, injected into the mouth, rectum 
or vagina after death, will diffuse itself through the body and 
may be found in the liver, lungs, kidneys and even in the brain 
a point of great importance in legal medicinef . 

Antidotes and Treatment in Cases of Poisoning. — The evacuation 
of the contents of the stomach by emetics or by the stomach- 
pump, if seen very soon after swallowing the poison, should be 
the first object in these cases. Demulcent drinks are to be also 
freely given. The ferric hydrate (Ferri Oxidum Hydratuni) 
should be administered, as soon as it can be procured, in the 
state of pulp or magma. It is prepared by the action of an alka- 
line solution on a ferric salt. Ammonia water is directed by 
the U. S. P. to be added to the solution of ferric iron (see pp. 160, 
162). The ferric hydrate is a soft, moist, reddish-brown magma, 
which acts as an antidote to arsenious acid by forming with it an 
insoluble, inert ferrous arseniate (Fe 3 2As0 4 ). The dose is about 
twelve times the supposed amount of poison taken, and it should 
be given in the fresh and pulpy state, as it gradually loses its 
antidotal virtues when kept. The ferric hydrate with mag- 
nesia {Ferri Oxidum, Hydratum cum Magnesia) is also directed 
to be kept in the shops as an antidote to arsenic. It should be 
administered in the same manner as ferric hydrate, and possesses 
the advantage of a tendency to act on the bowels. 

Dialyzed Iron is also an antidote to arsenic in the stomach. 
To insure its conversion into ferric hydrate, its ingestion should 
be followed by the administration of a tablespoonful of sodium 
chloride. Light magnesia (which has not been too strongly cal- 
cined) and freshly-precipitated gelatinous magnesia may be also 
used as antidotes. The after-treatment consists in the use of 
demulcents, opiates, and, if necessary, stimulants. 

Medicinal Uses. — Arsenious acid is a very valuable alterative 
remedy, but it must be exhibited with caution. It is employed 
with the greatest success in the treatment of chronic miasmatic 
affections, as dumb-ague, especially such as have resisted the use 



*"Compte Rendus des Seances," H, 6ieme Ser.,p. 304. 
f Journ. Amer. Med. Assoc, Aug. 4th, 1883. 



ALTERATIVES PREPARATIDN3 OF ARSENIC. 445 

of cinchona, or have frequently re-appeared. For this purpose 
it should be given in the dose of gr. yV - T2 thrice daily, after 
meals, and the quantity gradually pushed until its effects are 
obtained, as upon the stomach. When the point of toleration is 
reached, the size of the dose can be regulated so that the medicine 
may be taken for a considerable period. 

In chronic cutaneous affections, particularly the scaly diseases 
(lepra, eczema squamosum, psoriasis and pityriasis), it is highly 
useful, but it should not be given while any acute inflammatory 
symptoms are present, or where there is much itching, burning, 
or heat of skin, as under these circumstances it is apt to increase 
the affection. Pemphigus is often benefited and sometimes 
cured by the judicious administration of arsenical preparations, 
as are also certain cases of acne, especially when occurring on 
the face and characterized by numerous, finely papular lesions. 
As arsenic exerts its influence on the rete mucosum particularly, 
it is more efficacious when the superficial layers of the skin only 
are involved. 

It is used also in certain affections of the nervous system, chorea 
in particular, over which it exercises a marked control ; in neu- 
ralgia, it is often of great value, especially when combined with 
iron and quinine ; in chronic rheumatism, in irritable dyspepsia, 
gastric ulcer, diarrhcea, bronchitis, phthisis (where there is not 
much hectic, nor rapid disintegration of tissue), and as a tonic 
generally, especially when anaemia is present, it is often com- 
bined with iron and quinine : 1^ Acidi arseniosi, gr. j ; quininse 
sulphatis, gr. xxiv ; ferri sulphatis exsiccati, gr. xij ; oleo-resinae 
capsici, gr. iv. M. et ft. pil. xxiv. Sig. — One pill may be taken 
immediately after meals three times a day. 

As an external application, arsenious acid has been applied to 
indolent sinuses, lupus, onychia maligna, etc., either pure or 
mixed with several parts of sulphur ; when thus used, it should 
be applied freely, as a large amount is more likely to render 
absorption impossible, by the rapid destruction of the tissues 
which it causes. A minute crystal of arsenic moistened with 
creasote on cotton will deaden the pain in the cavity of a carious 
tooth. It is an ingredient of various empirical compounds 
employed in the treatment of cancer. 



446 MATERIA MEDICA HEMATICS. 

Administration. — Dose, gr. /g - -^ , in pills with bread-crumb, 
t. d., to be reduced when conjunctivitis appears, and suspended 
after the establishment of the oedema arsenicalis ; and after being 
taken a fortnight, it should always be intermitted for a day or 
two. It is less apt to occasion gastric irritability when given 
immediately after a meal. The usual and safer form of exhibiting 
this remedy is that of solution with potash. 

Liquor Potassii Arsenitis (Solution of Potassium Arsenite) 
(HK 2 As0 3 ), or Fowler's Solution. This is prepared by boiling 1 
part of arsenious. acid and potassium bicarbonate, each, in 10 
parts of distilled water, and when dissolved, adding 3 parts of 
compound spirit of lavender, and water enough to make the solu- 
tion weigh 100 parts ; allow the solution to stand for eight days and 
then filter. It is a transparent liquid, of an alkaline reaction, and 
has the color, taste and smell of spirit of lavender. It is decom- 
posed by the reagents which act upon arsenic, and is incompatible 
with infusions and decoctions of cinchona. Its effects and uses 
are analogous to those of arsenious acid, though some practi- 
tioners have denied their therapeutic identity. The treatment in 
acute poisoning is the same as that for arsenious acid. 

Fowler's solution is administered internally in the same dis- 
eases in which arsenious acid is given. When arsenic is to be 
prescribed for a long time, the acid itself should be selected, but 
when used for a short period, or to produce a constitutional 
impression rapidly, the more soluble arsenical preparations are 
preferred (Fowler's solution, sodium arseniate, or its solution, 
etc.). The solution of potassium arsenite is the most available 
form of arsenic for administration in the various forms of chronic 
skin diseases which have already been alluded to {vide p. 445), 
and may be advantageously combined with the bitter wine 
of iron, which will often prevent the gastro-intestinal derange- 
ment which is otherwise likely to ensue. The average dose in 
these cases is ^ij-iv, t. d., prescribed with food or directly after- 
ward, always carefully watching and guarding against the super- 
vention of toxic symptoms. 

It is a good tonic, also, in anaemia, and in chlorosis especially, 
when the subject is a young girl just arriving at the age of 
puberty, where iron disorders the digestion, or where the early 



ALTERATIVES PREPARATIONS OF ARSENIC. 447 

stage of tuberculosis is suspected. It is well to administer it 
for a week or more continuously, and to alternate with a less 
soluble form of arsenic. 

In irritative dyspepsia, flgj-ij well diluted, before meals, is of 
great value. In gastric ulcer * the same treatment is recom- 
mended, combined with a milk diet and regulation of the 
bowels. It appears to lessen the amount of sugar in the urine 
in diabetes mellitus, and has been used internally and hypoder- 
mically with varying results in the treatment of relapsing fever. 
As a tonic it is well combined with syrup of calcium lacto- 
phosphate. Dose, *KJ-x, t. d. Each fluidrachm contains of arseni- 
ous acid, gr. -^. 

Sodii Arsenias {Sodium Arseniate) (Na 2 HAs0 4 .7H 2 0), is 
made by melting together arsenious acid, sodium nitrate and 
sodium carbonate, then dissolving the fused salt in boiling water, 
and afterward crystallizing. In this process the arsenious acid 
is oxidized into arsenic acid by the nitric acid of the sodium 
nitrate, and then combines with the soda of both salts to form 
colorless, transparent, prismatic crystals, slightly efflorescent, 
very soluble in water, of a somewhat saline, slightly acrimonious 
taste. 

This salt is employed to fulfill the therapeutic indications of 
the other arsenical preparations, and has the advantage of a 
somewhat milder local action. Dose, gr. y^— i- ^ ^ s prescribed 
sometimes externally in the form of baths, in chronic nodose 
rheumatism and gout, 5ss-iij in each bath. It is generally used 
internally in the form of — 

Liquor Sodii Arseniatis [Solution of Soditim Arseniate), made 
by dissolving I part of sodium arseniate (rendered anhydrous at 
a heat not exceeding 300 ) in 99 parts of distilled water ; dose, 
gtt. x-xx. Cigarettes made of paper saturated with a solution, 
two or three times the officinal strength, are smoked in asthma. 
• Liquor Acidi Arseniosi {Solution of Arsenious Acid) (for- 
merly called solution of arsenic chloride) is made by boiling 1 part 
of arsenious acid with 2 parts of hydrochloric acid and 25 parts 
of distilled water, until the acid is dissolved, and adding to the 
solution, when cold, water enough to make it weigh 100 parts. 

* Brit. Med. Jour., 1884, p. 1203, Strahan. 



448 MATERIA MEDICA — HEMATICS. 

Dose, the same as that of Fowler's Solution, than which it is 
thought to be less apt to disturb the stomach. 

Arsenii Iodidum {Arsenic Iodide) (Asl 3 ), made by rubbing 5 
parts of iodine and I part of arsenic together, is an orange-red 
crystalline, volatilizable solid, wholly soluble in water, and has 
been used both internally and externally in skin diseases. Dose, 
gr. \, t. d. ; for external use, gr. iij to lard oj. 

Liquor Arsenii et Hydrargyri Iodidi (Solution of Arsenic 
and Mercuric Iodide). This solution, known as Donovan's Solu- 
tion, is prepared by dissolving 1 part of arsenic iodide and mer- 
curic iodide, each, in enough distilled water to make the solution 
weigh 100 parts. It is merely an aqueous solution of the two 
iodides (Asl 3 and Hgl 2 ). It has a pale-yellow color, a slightly 
styptic taste, and is incompatible with the salts of the alkaloids 
and the alkalies. 

Effects and Uses. — This is a highly valuable alterative prepara- 
tion in the various forms of papular and scaly cutaneous affec- 
tions, and in obstinate syphilis. It was introduced by Mr. 
Donovan, of Dublin, in 1839, an d has been a good deal em- 
ployed in the United States. Dose, gtt. v to xx or more, t. d. 

CALCII PHOSPHAS PR^CIPITATUS PRECIPITATED CALCIUM 

PHOSPHATE. 

This salt is made by reacting upon bone-ash with hydro- 
chloric acid, which dissolves the calcium phosphate in the bones, 
and gives it up again on the addition of water of ammonia. It 
is a white, inodorous, tasteless, insoluble powder, sometimes 
called the bone phosphate of calcium (Ca 3 2P0 4 ). It is an import- 
ant and valuable medicine, not only in diseases of deficient 
ossification, as ununited fractures, caries of the bones, rickets, 
etc., but in all conditions of defective cell-growth and mal-nutri- 
tion, from its undoubted influence in promoting natural cell- 
growth and nutrition. Thus it is employed (often in connection 
with other phosphates, as those of iron, sodium and potassium) 
in scrofula, phthisis, anaemia, diarrhoea, chronic bronchitis, 
abscesses, prolonged suppurations, and wasting diseases of every 
kind. On account of its insolubility it is apt to form intestinal 
concretions. Dose, gr. v-x, given dusted into a little milk. A 
better (because more soluble) preparation is the syricp of calcium 



ALTERATIVES — CALCIUM HYPOPHOSPHITE. 449 

lacto-phosphate (syrupus calcii lacto-phospliatis), containing lactic 
acid, calcium phosphate, orange-flower water, sugar, hydro- 
chloric acid, ammonia water and water. An emulsion containing 
50 per cent, of cod-liver oil with syrup of the lacto-phosphate 
is an excellent preparation. Dose, f5j-iv. 

CALCII HYPOPHOSPHIS CALCIUM HYPOPHOSPHITE. 

This salt is prepared by boiling phosphorus in a mixture of 
calcium hydrate in boiling water; phosphoretted hydrogen 
escapes, and calcium phosphate and hypophosphite are formed 
in the liquid, from which the insoluble phosphate and residuary 
lime are separated by filtration, and the hypophosphite 
(CaH 4 2P0 2 ) is afterward crystallized out in the form of white, 
pearly crystals, of a nauseous, bitter taste, soluble in six parts of 
water, and insoluble in strong alcohol. All the soluble sulphates 
and carbonates produce precipitates with this salt. 

Potassii Hypophosphis — Potassium Hypophosphite (KH 2 - 
P0 2 ) — is prepared by mixing solutions of calcium hypophosphite 
and potassium carbonate. It occurs in white, opaque, confused 
crystalline masses, having a disagreeable, bitter taste, very deli- 
quescent and very soluble in water and alcohol, but insoluble in 
ether. 

Sodii Hypophosphis — Sodium Hypophosphite (NaH 2 P0 2 .- 
H 2 0) — is prepared by mixing solutions of calcium hypophosphite 
and crystallized sodium carbonate, and crystallizes in white tables 
of a pearly lustre, very deliquescent (but less so than potassium 
hypophosphite), very soluble in water and alcohol, and insoluble 
in ether. 

The hypo phosphites have been introduced in the treatment of 
phthisis under an impression that they prove useful by furnishing 
phosphorus to the tissues. They more probably act by stimula- 
ting cell-growth and nutrition, and may be given to fulfill the 
same indications as the precipitated calcium phosphate. They 
are incompatible with the soluble salts of mercury and silver. 
Dose, gr. x-xxx t. d. The calcium hypophosphite is the most 
eligible salt, but they are often given together in the form of — 

Syrupus Hypophosphitum — Syrup of Hypophosphites — 
consisting of calcium hypophosphite 35 parts, sodium and potas- 
sium hypophosphites each 12 parts, dissolved in water by the aid 
29 



450 MATERIA MEDICA HEMATICS. 

of citric acid I part, and flavored with spirit of lemon, 2 parts, 
of sugar 500 parts ; the whole to weigh 1000 parts. It is a 
good preparation to fulfill the indications of the hypophosphites. 
Dose, f5j-ij. 

Syrupus Hypophosphitum cum Ferro — Syrup of Hypophos- 
phites with Iron — contains ferrous lactate 1 part, dissolved in 
syrup of hypophosphites, 99 parts. It is used for the same pur- 
poses and in the same doses as the last preparation. Ferric hypo- 
phosphite has been noticed with chalybeates (see p. 165). 

CALCII CHLORIDUM CALCIUM CHLORIDE. 

This salt (CaCl 2 ) is prepared by neutralizing hydrochloric acid 
with chalk or white marble, and adding a little chlorinated lime 
and slacked lime. It is a colorless, translucent salt, very deli- 
quescent, readily soluble in both water and alcohol. It should 
not be confounded with chlorinated lime, which is also sometimes 
called " chloride of calcium." 

It resembles the calcium preparations generally in its effects, and 
is a very efficient remedy in all strumous affections of children, 
as glandular enlargements, accompanied by colliquative diarrhoea, 
a coated tongue and fetid breath (Coghill*). Milk is a good 
vehicle in which to give it. It is also given with benefit in 
wasting diseases generally and in consumption. Dose, gr. v-xx. 

AMMONII CHLORIDUM AMMONIUM CHLORIDE. 

This salt, formerly termed ammonia muriate, and often known 
as sal ammoniac, is obtained from the gas-liquor of coal-gas 
works (usually by neutralizing the ammonia with hydrochloric 
acid), and also in the preparation of animal charcoal from bones. 
It is brought in the crude state from Calcutta, for use in the arts, 
and in the refined state, for medicinal employment, from England. 
It occurs in white, translucent, tough, fibrous, hemispherical, 
convex-concave cakes (NH 4 C1), about two inches thick, difficult 
to powder, inodorous, of a pungent, saline taste, slightly deliques- 
cent, very soluble in water, and less so in alcohol. 

For medicinal use it is purified by the addition of water of 
ammonia to a solution of chloride, and occurs as a snow-white 

* The Practitioner, XIX, p. 247. 



ALTERATIVES AMMONIUM CHLORIDE. 45 I 

crystalline powder, soluble in 2^ parts of cold and in its own 
weight of boiling water, and soluble also in alcohol. 

Effects and Uses. — The physiological effects of the ammonium 
salts have been considered under the head of Ammonia Prepara- 
tions (vide p. 212). The local action of ammonium chloride is 
that of an irritant. In large doses it purges. In small doses, 
after absorption, it proves a powerful resolvent-alterative, dimin- 
ishing the solid constituents of the blood, with an increased flow 
of the secretions generally ; it has an especial action upon the 
mucous membranes, promoting nutritive changes and epithelial 
exfoliation. Under its use the solids of the urine are increased, 
except uric acid, which is slightly diminished. Even in very 
large amounts it is not considered poisonous. 

It is not much employed either in Great Britain or the United 
States, but is extensively used in Germany as a refrigerant in mild 
fevers attended with stoppage of the secretions ; as a resolvent in 
organic enlargements ; in amenorrhcea, and in catarrhs, urethritis, 
etc. It is also used in bronchitis and pneumonia as an expecto- 
rant, combined with fluid extract of glycyrrhiza (which somewhat 
disguises its unpleasant taste) and with other expectorants : 
1^ Ammonii chloridi, 5ij ; extracti glycyrrhizae jluidi, f 5j ; syrupus 
ipecacuanhae, f 3iv ; syrupus pruni virginianae, f§iij ; syrupus 
tolutani, q. s. foyj. M. et Sig. — A dessertspoonful every three 
or four hours in acute bronchitis when expectoration is begin- 
ning to be established. Of late this salt has been used with 
advantage in muscular rheumatism and in neuralgia; and its 
resolvent powers are highly spoken of in fibroid tumors of the 
uterus. Dr. Peters* advocates its use in large doses combined 
with Huxham's tincture in rheumatic affections of the joints. 
In albuminoid or waxy infiltration of the liver, it is of undoubted 
avail in doses of gr. x-xx t. d. 

In the early stages of cirrhosis of the liver it is of value, and 
it has been highly recommended in torpidity of the liver, chronic 
hepatitis, etc., but according to the experiments of Rutherford and 
Vignal, it does not increase the secretion of bile, although they 
found it stimulated the intestinal glands. Dose, gr. v-xxx every 
two or three hours, in powder or mucilaginous solution. Exter- 

* N. Y. Med. Rec, Jan. 23d, 1886. 



452 MATERIA MEDICA HEMATICS. 

nally it is used in solution (immediately upon being dissolved) as 
a refrigerant lotion (Sj to water Oss), in cutaneous affections and 
indolent ulcers (5j to water Oss). Troches of ammonium chloride 
each contain ammonium chloride gr. ij with sugar, tragacanth, 
and syrup of tolu. 

AMMONII PHOSPHAS AMMONIUM PHOSPHATE. 

This salt enjoys considerable reputation as an alterative. It 
is made by adding stronger water of ammonia to diluted phos- 
phoric acid, evaporating and crystallizing ([NH 4 ] 2 HP0 4 ). It 
occurs in transparent, colorless crystals, having the form of six- 
sided tables, of an alkaline, somewhat saline taste, soluble in 
water, and insoluble in alcohol. As usually found in the shops, 
it is a mixture of the neutral and of the acid ammonium phos- 
phate. 

Effects and Uses. — It has been used in this country as a 
remedy in gout and rheumatism. In combination with ammo- 
nium carbonate and aromatic spirit of ammonia, it has been also 
used with advantage in diabetes. Dose, gr. x-xl three or four 
times a day, dissolved in an aromatic water. 

POTASSII CHLORAS POTASSIUM CHLORATE. 

This salt is prepared by various processes : a good one is by 
reaction upon solution of caustic potassa, mixed with lime, with 
a stream of chlorine ; the chlorine is converted into chloric acid 
by oxygen from the lime, and the acid combines with the po- 
tassium to form potassium chlorate (KC10 3 ). It is a white, an- 
hydrous salt, crystallizing in rhomboidal plates of a pearly lustre, 
and is inodorous, and of a cool, saline taste. It is but little 
changed by exposure to the air; it is soluble in 16 parts of cold 
water or 2 parts of boiling water. It is said to be soluble in all 
the animal fluids without decomposing them or undergoing 
change itself. 

Effects and Uses. — In its effects potassium chlorate resembles 
the other potassium salts (see p. 244), especially the nitrate. 
Introduced by the stomach, it is rapidly absorbed unaltered 
(Isambert * ). When taken internally for some time, it gives a 

* " £tudes clin., physiol., et chim. sur l'emp. therap. du chlorate de potassse," 
1856, Paris. 



ALTERATIVES — POTASSIUM CHLORATE. 453 

bright, arterial tinge to the venous blood, and reduces the 
volume and frequency of the pulse. It does not diminish the 
excretion of urea, but largely increases the secretion of urine, 
by which it rapidly passes out of the system unchanged, as well 
as by the saliva (Rabuteau *). It has been pointed out by Dr. 
Jacobi that when given for some time this salt produces irritation 
of the kidneys and finally chronic tubal nephritis. The appetite 
is improved under its use, and salivation is an occasional effect. 

Large doses may be taken with impunity, but excessive 
quantities have produced fatal gastro-enteric inflammation. In 
the case of Dr. Fountain,! who died from swallowing 5j, taken 
to prove its inertness, violent gastro-enteritis set in, and at the 
end suppression of urine, with death in seven days. Fatal cases 
of poisoning from this salt have been reported, apparently from 
blood poisoning, the heart and large vessels having been found 
filled with coagula. 

As it contains a large supply of oxygen, it was at first em- 
ployed with a view to its oxidizing influence in contaminated 
conditions of the blood, as in malignant fevers, etc., but as it 
does not part with oxygen except when exposed to a very high 
temperature (67 1° F.), this view of its action is scarcely tenable. 
It is still considered a valuable alterative in typhus, scarlatina, 
etc., by many practitioners. Probably its most positive remedial 
effects are seen in various forms of stomatitis, follicular, mercu- 
rial and gangrenous. It is used also in diphtheria, croup, 
cyanosis, asthma, and even neuralgia. Externally, in solution, 
it is an admirable wash or gargle in stomatitis, ozaena, the sore 
throat of scarlatina, subacute and chronic pharyngitis, diphtheria, 
and fetid, ulcerated surfaces generally ; mixed with sugar, the 
powder is an excellent application in the aphthous sore mouth 
of children. 

Dose, internally, gr. v-xxx three or four times a day, in some 
pleasant vehicle. It should not be prescribed in powder with 
the metallic sulphides, glycerin, vegetable powders, as tannin, 
catechu, etc., as when triturated with these substances it parts 
with some of its oxygen and forms explosive compounds. Tro- 
ches of potassium chlorate [trochisci potassii chloratis) are made by 

* Gaz. Hebdom., v, 1868, p. 705. f Am. Med. Times, 1861, p. 245. 



454 MATERIA MEDICA HEMATICS. 

rubbing together potassium chlorate, sugar, tragacanth, spirit of 
lemon, and with water forming a mass ; each troche contains 5 
grains of potassium chlorate. For external use, 5ij-iv may be 
dissolved in water, Oss. 

Sodii Chloras {Sodium Chlorate) (NaC10 8 ). This salt may be 
made in the same way as potassium chlorate, substituting a solu- 
tion of soda for that of potassa. It occurs as colorless, transpa- 
rent tetrahedrons, permanent in dry air, odorless, with a cooling 
saline taste, readily soluble in water, soluble also in alcohol. 

In effects and uses it is similar to potassium chlorate, but 
milder in its action. It is not much used internally. Dose, gr. 
v-xx. 

POTASSII BICHROMAS POTASSIUM BICHROMATE. 

The chief ore from which salts containing chromium are 
obtained is chrome ironstone, found in Sweden and in south- 
eastern Pennsylvania. By roasting the powdered ore with potas- 
sium carbonate and nitre, the (yellow) potassium chromate is 
obtained, and by acidulating a solution of this with sulphuric 
acid, the (red) bichromate is formed (K 2 Cr 2 7 ) ; it separates in 
orange-red, anhydrous, tabular crystals, soluble in water, insoluble 
in alcohol, and of a cooling, bitter taste. 

Effects and Uses. — It is an irritant caustic, acting in overdoses 
as a corrosive poison, for which the proper antidotes are mag- 
nesia, soap and the alkaline carbonates. In small doses it is 
alterative, and has been used in syphilis. In large doses it is 
emetic. Two drachms have caused death,* while a youth f 
recovered after taking §ij, though it produced severe gastro- 
enteric inflammation. Externally it is a good application, in 
powder or in saturated solution, to syphilitic warts, excrescences, 
etc. Dose, as an alterative, gr. \ daily, in pill, with some bitter 
extract ; as an emetic, gr. \. 



ORDER III. ANTACIDS. 

Antacids are rhedicinal agents employed to neutralize acids in 
the blood, primae viae and secretions. The alkalies and alkaline 
earths and their carbonates are the substances included in this 

* Woodman and Tidy, 1882, p. 169. f Guy's Hosp. Reports, 185 1, p. 214. 



ANTACIDS. 455 

division. The alkalies, in the concentrated state, destroy organi- 
zation and act as corrosive poisons; they are administered 
internally only in a state of extreme dilution. The alkaline car- 
bonates produce a less intense chemical action on the tissues than 
the alkalies ; and the bicarbonates are less active than the mono- 
carbonates. The alkaline earths, particularly magnesia, ate less 
energetic in their local action than the alkalies proper ; and their 
carbonates manifest little or no chemical influence upon the 
tissues. 

When swallowed in a state of dilution, the alkaline prepara- 
tions combine with the free acids which they encounter in the 
stomach. The salts which are thus formed, unless carried off 
by the bowels, are absorbed into the blood, and are thrown out 
by the secretions, especially by the kidneys. It must be remem- 
bered that, as already stated (see p. 245), alkalies increase acid 
and diminish alkaline secretions, when in contact with the orifices 
of the glands which secrete them. In like manner, acids increase 
alkaline and diminish acid secretions (Ringer) (see pp. 169, 
249). While in the intestines, besides neutralizing acids, the 
alkalies also promote the digestion and absorption of fatty sub- 
stances, by forming with them an emulsion. After absorption 
they exert a liquefacient action on the blood, and render the 
urine alkaline. Their long-continued use disorders the functions 
of digestion and nutrition, produces a chronic deterioration of 
the blood, and sets up a cachectic condition somewhat analogous 
to scurvy. 

In the concentrated form the alkalies are employed as escha- 
rotics. The various alkaline preparations are administered, 
internally, in the diluted form — 1. As antacids, in dyspepsia 
accompanied with excess of acid in the primae vise, and they are 
probably also of advantage in dyspeptic cases, by promoting the 
digestion of fatty matters. As dyspepsia with acidity probably 
depends frequently on fermentation of the ingesta, due to deficient 
secretion of acid gastric juice, the administration of alkalies would 
prove of advantage, not by neutralizing the acid in the stomach, 
but by correcting the deficiency of .the secretion on which the 
dyspepsia depends. If the condition, on the other hand, depend 
on a profuse secretion of acid, then the administration of alkalies 
can do nothing more than palliate, by neutralizing, the excessive 



456 MATERIA MEDICA HEMATICS. 

acidity. When alkalies are exhibited before meals, they increase 
the acid secretion of the gastric mucous membrane ; given after 
meals they neutralize the excess of acid. Acids taken before 
meals decrease the amount of acid secreted by the stomach ; 
while, if given after meals, they will supply the place of the acid 
of the gastric juice, should there be a deficiency in that secretion. 
The vegetable tonics and aromatics are frequently combined with 
antacids, very advantageously, in the treatment of dyspepsia. 
2. To relieve irritability of the stomach and check vomiting. 3. 
As antidotes in cases of poisoning from acids. 4. As antilithics, 
to neutralize lithic acid when it is separated in undue quantity 
by the urine ; and also as lithontriptics, or solvents of calculi, 
especially lithates. They are improper when there is a tendency 
to the deposition of phosphates ; and in treating cases of uric 
acid .deposit it is unnecessary to render the urine more than 
neutral, as, if it be made alkaline, the phosphates formed may be 
deposited round the uric acid calculi. 5. In the treatment of 
acute rheumatism and gout, where they act by neutralizing the 
excess of acid with which the blood is charged in these diseases. 
6. To relieve irritability of the urinary organs — ardor urinae in 
gonorrhoea — cutaneous irritation— uterine irritation — pruritus ani, 
etc. — especially when these conditions of irritability are dependent, 
as is often the case, on excess of acid in the system. 7. As diu- 
retics (see p. 366). 8. As antiplastics and resolvents, in inflamma- 
tion. And, 9. By many therapeutists, in diabetes mellitus. 

The antacid preparations should be administered in a state of 
large dilution, with a view to facilitate their absorption, and to 
prevent an irritant and purgative action on the bowels. 

POTASSII PRiEPARATA POTASSIUM PREPARATIONS. 

The preparations of potassium employed as antacids are the So- 
lution of Potassa, Potassium Carbonate and Potassium Bicarbonate. 

The general effects of the potassium preparations are those 
previously described (see p. 244). They increase both the solid 
and watery portions of the urine, and in large doses render it 
alkaline. Under their use, however, the uric acid, either free or 
combined, is greatly diminished, and, it is asserted, is converted 
into oxaluric acid, which is metamorphosed into oxalic acid and 
urea. 



ANTACIDS — POTASSIUM PREPARATIONS. 457 

Liquor Potassa {Solution of Potassa) is prepared by the action 
of lime on a solution of potassium bicarbonate ; the lime abstracts 
carbonic acid from the bicarbonate, and precipitates as calciurh 
carbonate, leaving the potassium hydrate in solution ; or it may 
be made, more directly, by dissolving potassa, 56 parts, in dis- 
tilled water, 944 parts. Solution of potassa is a limpid, colorless 
liquid, without smell, of a very acrid, caustic taste, an alkaline 
reaction, and imparts a soapy feeling to the fingers when rubbed 
with it; sp. gr. 1.036; it contains 5 per cent, of potassium 
hydrate (KHO). 

Effects and Uses. — The antacid, diuretic, antilithic and resolvent 
properties and indications of this preparation have been described 
above. It is more irritant to the stomach than the potassium 
carbonates, and is therefore less eligible for protracted use. To 
render the urine alkaline in cystitis, Sir H. Thompson prefers it 
to the carbonates and citrates, as it is less diuretic. For the same 
reason it is useful in gonorrhoea. In excessive quantity it may 
act as an irritant and corrosive poison ; vegetable acids should 
be administered as a chemical antidote, and oils as a protective. 
Dose, gtt. x-xx, largely diluted with sweetened water or muci- 
lage. Externally it is used in a diluted state as a stimulant 
lotion. 

Potassii Carbonas {Potassium Carbonate, commonly called 
Salt of Tartar). This salt is prepared by calcining potassium 
bicarbonate, which is thus deprived of a molecule of carbonic 
acid and reduced to the state of carbonate (2KHC0 3 = H 2 C0 3 + 
K 2 C0 3 ). Potassium carbonate occurs in the form of a white, 
coarse, granular powder, of a nauseous, alkaline taste and an 
alkaline reaction, very soluble in water, but insoluble in alcohol. 
It is very deliquescent, forming, if long exposed to the air, an 
oily liquid with the water which it attracts. Acids, acidulous 
salts and many other substances are incompatible with it. 

It is employed as an antacid, anaplastic, diuretic, antilithic, etc., 
in the dose of gr. x-xx, in some sweetened aromatic water. It 
has been found specially useful in torpor of the liver and in 
whooping-cough. In large quantities it acts as a corrosive poison, 
for which vegetable acids are the chemical antidotes. 

Potassii Bicarbonas {Potassium Bicarbonate) is made by pass- 
ing carbonic acid through an aqueous solution of purified pearl- 



45^ MATERIA MEDICA HEMATICS. 

ash (a more or less impure potassium carbonate), obtained from 
wood-ashes by lixiviation, and somewhat purified by solution in 
water, filtration and evaporation, till it is fully saturated. It 
occurs in transparent, colorless crystals, having the shape of 
irregular eight-sided prisms with two-sided summits (KHC0 3 ). 
They are inodorous, of a slightly alkaline taste, permanent in the 
air, soluble in water and insoluble in alcohol. The effects and 
uses of this salt are the same as those of the carbonate, but it is 
pleasanter in taste and less irritant to the stomach. It is much 
used in gout and uric acid lithiasis. Dose, gr. xx-5j. It is a 
good remedy in acute rheumatism, in which as much as Sjss 
may be given during the day, with opium to relieve pain. 

Fuller's alkaline* treatment of acute rheumatism consists in 
giving large doses so as to thorougly alkalinize the system, 
together with the strictest attention to the diet and the adminis- 
tration of tonics, as quinine, as soon as the system will tolerate 
them. He gives of potassium bicarbonate not less than Sjss in 
the first twenty-four hours, either alone or in combination with a 
vegetable acid largely diluted with water. When the urine 
becomes neutral the bicarbonate is reduced to a quantity just 
sufficient to keep it so (from 5/^— J^ thrice daily). Of 439 cases 
treated by this plan, in only 2 per cent, were cardiac complica- 
tions discovered. Fuller's treatment is best adapted to the obese 
and plethoric. 

SODII PR^PARATA SODIUM PREPARATIONS. 

The sodium preparations are analogous in effects to those of 
potassium. Ringer and Sainsburyf have shown that they stop 
the extirpated frog's heart in diastole. Schoenlein J, too, found 
that sodium carbonate acted directly on the heart and not 
through the nerves. In regard to their relative poisonous 
activity, the former ascertained that potassium stood first, then 
ammonium, while sodium possessed only slight toxic power. 
Being less irritant and less depressing, they are better as anti- 
dyspeptics, and for the relief of acidity of the primae viae. They 
are inferior in gout and uric acid lithiasis, as they are less power- 



* The Practitioner, Vol. II, p. 129. f Lancet, 1882, p. 736. 

\Arch.f. d. Ges. Physiol., XVIII, p. 26. 



ANTACIDS SODIUM PREPARATIONS. 459 

ful solvents of this acid. Their eliminative action as diuretics 
is also more feeble. 

Liquor Sod,e {Solution of Soda) is prepared by the action of 
lime on a solution of sodium carbonate, or by dissolving soda 56 
parts in distilled water 944 parts. It is a colorless liquid, having 
an extremely acrid taste and a strong alkaline reaction. It has 
sp. gr. 1.059, and contains 5 percent, of sodium hydrate (NaHO). 
The dose and administration are the same as those of liquor 
potassae. 

The preparations of sodium generally employed as antacids 
are the carbonates. There are several sources of carbonated 
sodium. The native carbonate (called natron) is found in Egypt, 
Hungary and other countries. Impure soda, obtained from the 
ashes of marine plants, is termed barilla or kelp — barilla when 
it is derived from phenogamous plants growing near the sea, 
and kelp when procured from cryptogamic plants growing in the 
sea. Sodium carbonate is now, however, chiefly made by artifi- 
cial means from sodium sulphate, which is obtained in part from 
the manufacturers of chlorinated lime, but principally by the 
action of sulphuric acid on sodium chloride. The sodium sul- 
phate is fused with ground limestone and coal, and forms a black 
mass called British barilla, which contains a mixture of sodium 
carbonate and calcium sulphide — Na 2 S0 4 + C 4 -f- CaC0 3 = 
CaS -f- Na 2 C0 3 + 4CO. It is afterward purified by lixiviation, 
calcination and other processes. Within a few years past, caustic 
soda and the carbonates and other sodium salts have been manu- 
factured near Pittsburgh, in Pennsylvania, from cryolite (a sodium 
and aluminium fluoride)' (3NaF,AlF 3 ), which is found in an 
immense deposit in Greenland, and largely imported into Phila- 
delphia. Recently, too, sodium carbonate has been found in 
large amount in a lake in Nevada. 

Sodii Carbonas (Sodium carbonate) (Na 2 C0 3 .ioH 2 0) crystal- 
lizes in large, oblique, rhombic prisms, which are transparent, 
very efflorescent, of an alkaline, disagreeable taste, soluble in 
water, but insoluble in alcohol. When heated they undergo the 
watery fusion and part with their water of crystallization, which 
is entirely expelled at a red heat. It is apt to contain sodium 
sulphate and chlorides as impurities. Acids, acidulous salts, lime- 



460 MATERIA MEDICA HEMATICS. 

solution, earthy and metallic salts, etc., are incompatible with 
sodium carbonate. 

Effects and Uses. — Sodium carbonate is less irritant and has a 
milder and more agreeable taste than potassium carbonate. Its 
effects are otherwise similar, and it is administered in the same 
cases. In overdoses it is a corrosive poison, for which acids and 
oils are the antidotes. Dose, gr. x-xxx in powder, or dissolved 
in some bitter infusion. Owing to the variable quantity of water 
of crystallization which it contains, as kept in the shops, it is best 
given in the dried state. 

Sodii Carbonas Exsiccatus {Dried Sodium Carbonate). — This 
salt is deprived of its water of crystallization by heat, and occurs 
in the form of a white powder. Dose, gr. v-xv in pill, made with 
soap and aromatics. 

Sodii Bicarbonas {Sodium Bicarbonate) (NaHC0 3 )is prepared 
by saturating the carbonate with carbonic acid. In the process 
followed in this country the water contained in the carbonate, 
which is liberated during the process of its saturation, is drained 
off. Thus obtained, the crystals have the form of the carbonate, 
retaining pnly one equivalent of water, but are opaque and porous. 
They occur usually in granular masses, or in the form of a white, 
opaque powder, which contains variable amounts of soda not 
fully saturated with carbonic acid, and is known as sodii bicar- 
bonas venalis {commercial sodium bicarbonate). This is purified 
for medicinal use by percolation with distilled water, and the 
purified salt occurs as a snow-white powder, soluble in 13 parts 
of water, of a mild, slightly alkaline taste. It is a permanent 
salt. By exposure to heat L gradually parts with its carbonic 
acid, and at a red heat is converted into the anhydrous carbonate. 

The effects and uses of this salt are the same as those of the 
carbonate, but it is less irritant and of more agreeable taste. 
Dose, for an adult, gr. x-xxx, which may be pleasantly taken in 
carbonic acid water. It is often combined with aromatics in acid 
dyspepsia or flatulence : ly Sodii bicarbonatis, 5ij ; tincturae nucis 
vomicae, f 5ij ; tincturae zingiberis, f 5iv ; tincturae capsici, f 5j ; 
sacchari albi, §ss ; aquae menthae piperitae, q. s. fSyj. M. S. Of 
this, a dessertspoonful may be taken three or four times a day. 
Sodium bicarbonate is an ingredient of Seidlitz powders (see p. 



ANTACIDS — LITHIUM PREPARATIONS. 46 1 

335). Troches of sodium bicarbonate contain sodium bicarbonate, 
sugar, nutmeg, and mucilage of tragacanth, each troche con- 
taining gr. iij of the bicarbonate. Sodium bicarbonate may be 
sprinkled with advantage over burns and scalds ; or a solution 
of 5/4 to water Oij may be applied to the parts, on lint, to alle- 
viate the pain (McClellan* and Spring f). Equal parts of it and 
common salt make a good application to the bites of bees, 
hornets, and spiders. 

LITHII PR^EPARATA — LITHIUM PREPARATIONS. 

Lithium is found in several minerals, as lepidolite, etc., but in 
minute amount. It is extracted chiefly by the agency of sul- 
phuric acid ; the sulphate is converted into a chloride by a solu- 
tion of barium chloride, and from the chloride, the carbonate 
(Lithii Carbonas) (Li 2 C0 3 ) is prepared by the addition of ammo- 
nium carbonate. It is a white powder, of a mild alkaline taste, 
soluble in 130 parts of water, more soluble in carbonic acid 
water, and insoluble in alcohol. 

The lithium salts act on the system in a similar manner to the 
other alkalies. They are said to render the urine more alkaline 
than do the other members of this group. Lithium carbonate is 
a very valuable antacid in gout and rheumatism, from the fact of 
its low combining number and the great solubility of the lithium 
urate, thus enabling the carbonate to act powerfully in eliminat- 
ing uric acid from the system. Garrod J, who first called atten- 
tion to lithium in the treatment of gout, experimentally proved 
its efficiency as a solvent of uric acid deposits by placing a meta- 
carpal bone and bit of cartilage, both of which were infiltrated 
with gouty nodules, in a solution of lithium carbonate, which, in 
a few days, dissolved away the deposit. It probably also dimin- 
ishes the formation of uric acid, and the author has found it 
highly efficacious in the cure of gout. It is, too, a good diuretic. 
Dose, gr. v-x two or three times daily, largely diluted, and best 
given in carbonic acid water. 

Lithii Citras [Lithium Citrate) (Li 3 C 6 H 5 7 ), a deliquescent 



* Louisville Med. News, 1878, p. 108. 

f Phila. Med. Times, March, 1878, p. 273. 

% " Gout and Rheumatic Gout," 1859, p. 435, 



462 MATERIA MEDICA HEMATICS. 

white powder, soluble in 5.5 parts of water, is made by adding a 
solution of citric acid to the lithium carbonate. It is converted 
into a carbonate in the system, and is, therefore, possessed of 
the same properties, but is more refrigerant. Strong solutions 
of lithium salts have been found useful externally in removing 
gouty enlargements. 

Lithii Benzoas {Lithium Benzoate) (LiC 7 H 5 2 ) is prepared by 
the gradual addition of benzoic acid to a heated watery solution 
of the carbonate, and evaporating. It may be obtained in the 
form of glistening pearly scales, of a soapy feel and a cool, 
sweetish taste, soluble in three and a half parts of water at 6o°. 
The ready solubility of this salt and its freedom from deliques- 
cence, and the benzoic acid which it contains in combination, 
give it especial value in the treatment of the various forms of 
disease dependent upon uric acid deposits. Dose, gr. iij-v 
repeated. 

AMMONII PR^PARATA AMMONIUM PREPARATIONS. 

The preparations of ammonium (previously noticed under the 
head of Stimulants, p. 211) are administered as antacids, in cases 
in which a stimulant action is not objectionable. Spiritus ammo- 
nice aromaticus [aromatic spirit of ammonia) is the preparation 
usually employed, and is an excellent antacid carminative in 
heartburn attended with flatulence, nausea with syncope, etc. 
Dose, gtt. xxx-f3j. 

MAGNESII PR^EPARATA — MAGNESIUM PREPARATIONS. 

Magnesia (p. 329) and its Carbonate (p. 330) are employed as 
antacids in dyspepsia, sick-headache, gravel, etc., particularly 
where a laxative effect is also desirable. Dose, gr. x-xxx. 
Troches of magnesia are made by mixing magnesia, nutmeg, 
sugar, and forming with mucilage of tragacanth a mass, each 
troche containing gr. iij of magnesia. 

CALCII PR.EPARATA — CALCIUM PREPARATIONS. 

The preparations of calcium employed as antacids are Lime- 
solution, Precipitated Calcium Carbonate, and Prepared Chalk. They 
are very useful in cases of acidity or irritability of the stomach, 
but their action on the bowels is the reverse of that of magnesia, 



ANTACIDS CALCIUM/ PREPARATIONS. 463 

and hence they can hardly be administered where there is a 
tendency to constipation. They are also much employed in 
diarrhoea, and occasionally as alterative resolvents in glandular 
enlargements, and to relieve irritability of the bladder from 
calculus. 

Liquor Calcis (Lime- Solution, Lime-water) is a saturated solu- 
tion of lime in distilled water. It is a colorless, inodorous liquid, 
of a disagreeable alkaline taste, containing about 0.15 per cent, 
of calcium hydrate (Ca2HO). By exposure to the air it 
gradually absorbs carbonic acid, with the formation of insoluble 
calcium carbonate. It should, therefore, be kept in full, well- 
stoppered bottles, or they should contain some undissolved 
lime. 

Effects and Uses. — Lime-solution combines antacid and astrin- 
gent properties, and is applicable to all the cases in which antacids 
are proper, where an astringent effect on the bowels is not 
objectionable. It is an excellent remedy in gastric irritability, 
attended with nausea and vomiting, and may be given mixed 
with an equal part of milk, which disguises its unpleasant taste. 
A diet of milk and lime-solution is very useful in dyspepsia 
accompanied with vomiting of food. Lime-solution is employed 
also in diarrhoea after inflammation has been subdued, in diabetes, 
and as an alterative-resolvent in glandular affections. Externally 
it is used as a wash in tinea capitis, prurigo, scabies, etc., as an 
application to foul ulcers, and as an injection in leucorrhcea and 
gleet. Atomized inhalations of lime-solution have been found 
useful in diphtheria and membranous croup. Dose, internally, 
fSss-iij-iv several times a day; for children, f5j. Linimentum 
calcis (lime -liniment) (equal parts of lime-solution with cotton -seed 
oil, sometimes called carron oil) is an invaluable liniment in 
burns and scalds, and in smallpox. 

Syrupus Calcis (Syrup of Lime) contains 5 per cent, of lime 
and 30 per cent, of sugar. It has been used as an astringent in 
diarrhoeas, and as an antidote to poisoning by carbolic acid. It is 
much stronger than lime-water — ^ X x of the syrup being equal 
to f§j of the latter. Dose, f oss— ij, well diluted. 

Calcii Carbonas Pr^ecipitatus (Precipitated Calcium Carbon- 
ate) (CaC0 3 ) is made by mixing boiling solutions of calcium chlo- 
ride and sodium carbonate. It is a fine white powder, insoluble 



464 MATERIA MEDICA TOPICAL MEDICINES. 

in water, and free from grittiness, but possessing no superiority 
over prepared chalk. 

Creta Pr^eparata (Prepared Chalk) (CaC0 3 ) is made from 
chalk or whiting by levigation and elutriation. It occurs in little 
white conical loaves, which are tasteless, odorless, insoluble in 
water, but more soluble in carbonic acid water. Its effects are 
those of an antacid and de sice ant-astringent. 

It is used in dyspepsia and gout attended with an excess of 
acid in the system ; also in diarrhoea ; and as it forms soluble 
calcium salts with the acids of the stomach, its employment has 
been suggested in rachitis. Dose, gr. x-xxx, in powder or sus- 
pended in water with gum and sugar. Pulvis cretce compositus 
(compound chalk-powder) is made by mixing prepared chalk (30 
parts) with powdered acacia (20 parts), and sugar (50 parts). 
Mistura cretce (chalk-mixture) consists of compound chalk-powder 
(20 parts) mixed with water and cinnamon water (40 parts of 
each) ; dose, foss, repeated. Laudanum and tincture of kino or 
of catechu, and aromatics, are often added to this mixture in the 
treatment of diarrhoea. Troches of chalk are made by mixing 
prepared chalk, acacia, nutmeg and sugar, and forming a mass 
with water ; each troche containing gr. iv of prepared chalk. 



CLASS IV, -TOPICAL MEDICINES. 

ORDER I.— ANTISEPTICS AND ANTIPYRETICS. 

Antiseptics (<W, against, and aijirros, putrid) are remedies which 
prevent fermentation and decomposition by a poisonous influ- 
ence on the protoplasmic germs on which those processes depend, 
while antipyretics (d>r{, against, and 7tdper6s, fever) are those which 
reduce the temperature of the body, such action being particu- 
larly conspicuous when the body-heat is elevated by a febrile 
process, and almost nil in the normal state. 

The antiseptic and the antipyretic properties of many sub- 
stances of this group bear a definite relation to each other, so 
that they are powerful in lowering febrile temperature in the same 
ratio as they are destructive to lower forms of life and especially 



ANTISEPTICS AND ANTIPYRETICS. 465 

is this the case with the lower members of the aromatic series of 
carbon compounds. 

The theory of putrefaction which, based upon the researches 
of Pasteur, has been steadily gaining ground and is now almost 
universally adopted, refers the changes which take place in decom- 
posing matter to the agency of organized germs ever present in 
the atmosphere, which, finding a suitable nidus in putrescible 
material, grow and multiply, producing chemical decomposition 
as a result of their presence. As in many diseases (e. g., relaps- 
ing fever, diphtheria, etc.) certain organized germs have been 
found to take an essential part in the diseased process, if not to 
produce it, and as their presence is suspected in many diseases 
in which as yet they have not been demonstrated to exist, the 
importance of a group of agents which are destructive to these 
low forms of life can hardly be exaggerated. The extent to 
which this group of remedies will destroy disease germs in the 
body without injuring the vitality of the human being, cannot be 
definitely laid down. Certain it is that as yet we possess very 
few specifics in medicine, especially against the zymotic diseases, 
which would appear a priori to be especially the class to which 
antiseptics would apply. Yet as many antiseptics are also anti- 
pyretics, they are not without use in the diseased economy, even 
if they do not cut short the morbid process. 

When applied topically antiseptics are of great value, not only 
as deodorants and disinfectants, but also as germicides in dress- 
ing wounds, ulcers, etc., as in Sir Joseph Lister's antiseptic 
method or its various modifications. They are also useful to 
prevent the spread of disease when added to the excreta of 
patients suffering from contagious affections. 

Antipyretics act * chiefly either to lessen the production of heat 
by retarding oxidation, and consequently cell-proliferation and 
chemical and molecular changes in the tissues, or by depressing 
the circulation either of the part (local abstraction of blood, 
blisters, etc.), or of the system at large (sedatives) ; or increase 
the loss of heat by increasing the evaporation of perspiration 
from the surface (diaphoretics) ; by dilating the cutaneous ves- 

* "A Text-book on Pharmacol., Mat. Med. and Therapeut." London, 1885, pp. 
53 and 366. By T. Lauder Brunton. 



466 MATERIA MEDICA TOPICAL MEDICINES. 

sels and thus promoting heat-radiation (alcohol, amyl nitrite, 
spirit of nitrous ether), or by abstracting heat directly from the 
surface (cold applications or drinks). Many of the antipyretics 
(e. g., sedatives, sudorifics, quinine, etc.), as well as of the anti- 
septics (alcohol, iodine, quinine and solutions of various metallic 
salts), have already been discussed, and it now remains to study 
those articles of the former group which are used to lessen heat 
production chiefly by retarding oxidation, as well as those reme- 
dies particularly employed as topical antiseptic agents. 

POTASSII PERMANGANAS POTASSIUM PERMANGANATE. 

This salt is made by mixing together equal parts of mangan- 
ese dioxide and potassium chlorate, dissolving in a little water, 
evaporating to dryness, and exposing to a nearly red heat. 
Potassium permanganate (K 2 Mn 2 8 ) occurs in the form of slender 
prismatic crystals of a deep purple color, inodorous and of a 
sweetish, astringent taste. It dissolves readily in water, making 
a beautiful lilac-solution, which is readily decolorized by Fowl- 
er's arsenical solution and organic matters. 

Effects and Uses. — There is little experience as regards the 
action of this salt when administered internally, although altera- 
tive effects are attributed to it (and probably with reason) in 
poisoned conditions of the blood, as in malignant fevers, diph- 
theria, pyaemia, erysipelas, puerperal fever, etc. It is also used 
with success in amenorrhcea ''Ringer), especially when of a 
purely functional character. It may be administered in gelatin- 
capsules ; dose, gr. j-ij t. d., taken for five days or a week before 
the expected period (H. M.). It is, however, as a powerful dis- 
infectant that it now claims chief attention, and it now ranks at 
the head of this class of agents in destroying fetid odors and 
poisonous organic emanations. Its power in this respect is due 
to the evolution of oxygen in its more active form, ozone. 

It is used externally in dressing foul and fetid or gangrenous 
ulcers, particularly in hospital gangrene, as an application to car- 
buncles, as a gargle in diphtheria, etc. It may be sprinkled in 
powder on gangrenous surfaces or applied in solution of the 
strength of half an ounce, an ounce, or two ounces, to a pint of 
water. As a disinfectant and deodorizer, a solution of from one to 
ten grains to an ounce of water may be exposed in saucers or 



ANTISEPTICS AND ANTIPYRETICS CHLORINATED LIME. 467 

sprinkled on the floor, or thrown into the air in spray by the 
atomizer. One to three grains may be given internally in solution 
through the day. Condy's Fluid contains gr. ij to the f§j. As 
an injection in go?wrrhce 'a potassium permanganate (gr. ij to water 
f 5j) is highly efficacious, especially where a profuse yellowish 
discharge exists. In using this remedy, care must be taken to 
avoid the introduction of organic matter into the solution, which, 
by reducing the salt to an oxide, will impair its efficiency. A 
good plan is to make the solution as required (C. B.). Milton * 
states that nothing approaches it in point of efficiency as an 
injection in gonorrhoea. 

AQUA CHLORI CHLORINE-WATER. 

This is an aqueous solution of chlorine, and should be kept in 
a cool place, protected from the light, but it is soon decomposed. 
It contains at least 0.4 per cent, of the gas. It occurs as a green- 
ish-yellow liquid, having an astringent taste and the suffocating 
odor of the gas. It is seldom used internally, but has been 
employed in essential malignant fevers, as scarlatina and typhus, 
and as an antidote for hydrocyanic acid. Dose, f oj-iv, diluted. 
Externally it is used, diluted, as a wash in skin-diseases, as an 
antiseptic, and by inhalation in bronchial affections. Chlorine 
acts as a disinfectant and deodorizer, chiefly by its affinity for the 
hydrogen of moisture and the liberation of oxygen ; its gaseous 
form gives it advantages in this respect. Solutions containing 
chlorine and other antiseptics are useful applications to suppu- 
rating surfaces, by preventing the decomposition of pus, and 
thereby pyaemia. In case of poisoning by chlorine-water, albu- 
men is the best antidote. 

CALX CHLORATA CHLORINATED LIME. 

This preparation, often called chloride of lime, is prepared by 
passing chlorine over calcium hydrate till saturation is effected, 
and is said to be principally a mixture of calcium hypochlorite 
and chloride (CaCl 2 2 and CaCl 2 ). It occurs as a loose, grayish- 
white powder, or friable lumps, dry or but slightly moist, readily 
soluble in water, of a bitter, caustic taste and a faint odor of 

* " On Gonorrhoea," etc., 1887, p. 201. 



468 MATERIA MEDICA TOPICAL MEDICINES. 

chlorine. Exposed to air and moisture, it slowly yields hypo- 
chlorous acid (HCIO), and this soon breaks up into water, chloric 
acid (HCIO3), and free chlorine, and the chloric acid again yields 
chlorine; 25 per cent, of chlorine should be furnished by good 
chlorinated lime. 

It has been used as an alterative in typhus, malignant scarlatina, 
etc., in doses of gr. j-v, in solution, several times a day; and as, a 
wash, externally, one part dissolved in a hundred parts of water ; 
or as a paste. It is chiefly, however, as a disinfectant that it is 
employed. Its effects are essentially those of chlorine, like which 
it decomposes hydrosulphuric and hydrocyanic acids, and should 
not be given with mercurials. 

Liquor Sod.e Chlorat.e (Solution of Oilorinated Soda) 
(NaCl,NaC10), sometimes termed Labarraque y s Disinfecting 
Liquid, is made by decomposing a solution of sodium carbonate 
by one of chlorinated lime. It is a transparent, greenish-yellow 
liquid, with a faint smell of chlorine, a sharp saline taste and an 
alkaline reaction. It has been used internally, to fulfill the same 
indications as chlorinated lime, in dose of ^x-f<5j, diluted, several 
times a day. It is useful, also, in dilution of various strengths, 
as an external application to every form of fetid ulcer, and is a 
most valuable and powerful disinfectant. 

Hydrargyri Chloridum Corrosivum — Mercuric Chloride. 
— Corrosive sublimate {vide p. 416) is very destructive to the lower 
forms of life, and is largely used for this purpose in the treatment 
of various surgical affections. It is employed in solutions (1 
to 1000,- 1 to 8000) as a prophylactic to cleanse the surface of 
the patient, and the hands, instruments, and sponges of tie sur- 
geon, previous to an operation, and in the form of corrosive sub- 
limated gauze, or cotton, as a dressing after the operation is 
finished, and thus prevent the entrance of the germs on which 
depend suppuration, erysipelatous or diphtheritic inflammation, 
and other complications of wounds. 

To destroy germs when already present, it is also useful. Thus, 
in the treatment of abscesses, either acute or chronic, after 
evacuating the contents through a small incision, the cavity 
should be super-distended with the corrosive sublimate solution 



ANTISEPTICS AND ANTIPYRETICS CHLORINATED LIME. 469 

(1-1000 or 1-2000) and the fluid retained from two to five min- 
utes, when it should be allowed to drain off, after which the 
injection is to be repeated until the fluid flows away as clear as 
when introduced. In this way we destroy the protophytes on 
which these forms of suppuration depend, and thus hasten the 
growth of granulations. In psoas, iliac or lumbar abscess this 
method of treatment probably gives the best results, and deep- 
seated mammary abscesses may be rapidly healed by its employ- 
ment. 

As numerous cases of poisoning are recorded, it is better to 
decrease the strength of the solution or to discontinue its use, and 
employ pressure to bring the walls of the abscess together, after 
a few days, when healthy granulations are springing up. 

As an injection in gonorrhoea, a weak solution (1-8000, or 
better, 1-12,000) may be used to destroy the gonococci, but even 
then severe pain and violent inflammation may be excited in the 
male urethra by such an injection. In gonorrhoea of the female, 
a corrosive chloride solution (1-8000) thrown into the vagina 
when the patient is in the recumbent position with the hips 
slightly elevated by a pillow is very efficacious. 

In the treatment of puerperal septicaemia, vaginal and even 
uterine injections are employed, care being taken in the latter 
case to throw the solution very slowly into the uterus, to be sure 
that it returns freely through the os uteri, to avoid the introduc- 
tion of air into the uterus and to discontinue the injection should 
much pain be complained of or symptoms of syncope or collapse 
supervene. 

It may be used not only as a dressing but also as a wash for 
all wounds and ulcers whatever. 

A solution of the required strength may be made as follows : 
1^ Hydrargyri chloridi corrosivi, 5j ; divide in chart vin. Sig. — 
One powder dissolved in a pint of hotwdXev forms a solution of 1 to 
1000; or, as the powders are somewhat difficult of solution, 1^ 
Hydrargyri chloridi corrosivi, 5j ; alcohol, f^ij. M. Sig. — f5ij, in 
a pint of water = 1 in 1000 parts. If the latter solution is to be 
kept for some time, it is well to add an equal weight of ammonium 
chloride to the corrosive sublimate to prevent decomposition of 
the latter salt. 

Compressed tablets are also kept in the shops, which are very 



470 MATERIA MEDICA TOPICAL MEDICINES. 

convenient for making solutions. If mercuric chloride be used 
to disinfect instruments, they should not be allowed to remain in 
the solution, as otherwise mercury will be deposited on the surface 
of the metal, and the instrument tarnished. Gauze, lint, cotton, 
wool, jute, saw-dust, etc., are impregnated with solutions of the 
corrosive chloride and used as surgical dressings. 



Bromine (see Escharotics) and iodine are antiseptics, acting in 
a manner similar to chlorine. They are seldom used for this 
purpose. 

Hydrargyri Iodidum Rubrum {Mercuric Iodide, vide p. 420) 
is also used in aqueous solution as an antiseptic (1 to 2000). 
It has not, however, replaced the mercuric chloride as a germicide. 

Acidum Sulphurosum {Sulphurous Acid) contains about 3.5 
per cent, of sulphurous acid gas in distilled water, and is made 
by heating sulphuric acid with charcoal and distilled water. The 
sulphuric acid is deprived of an equivalent of oxygen by the 
charcoal, and becomes sulphurous acid (H 2 S0 3 ). It is a colorless 
liquid, having the smell of burning sulphur and a sulphurous, 
sour, and somewhat astringent taste. It is a powerful deoxidizing 
agent, very destructive to vegetable life, and is believed to exert 
a similar influence on disease germs. It is readily absorbed by 
the stomach, and is eliminated by the urine and feces as a 
sulphate. Internally, it is very efficacious in sarcina ventriculi, 
or yeast vomiting; dose, f5j, largely diluted with water. Exter- 
nally, it is used in skin diseases (particularly those of a parasitic 
nature, either animalcular or cryptogamous), diluted with two or 
three measures of water or glycerin. 

Sodii Sulphis {Sodium Sulphite) (Na 2 S0 3 .7H 2 0) is used as a 
substitute for sulphurous acid, which is developed from the salt 
by any of the organic acids. It occurs in white, efflorescent, 
prismatic crystals, of a' sulphurous taste, soluble in four parts of 
cold and one part of boiling water. Dose, 5j, three times a day; 
a solution (5j-f5J of water) is a good /^^/application in erysipelas. 

Sodii Bisulphis {Sodium Bisulphite) (NaHS0 3 ) occurs in 
opaque, prismatic crystals or a crystalline or granular powder, 



ANTISEPTICS AND ANTIPYRETICS BORIC ACID. 47 1 

slowly oxidizing and losing sulphurous acid on exposure to air, 
having a faint sulphurous odor and taste, soluble in 4 parts of 
cold and 2 parts of boiling water. It is used as a substitute for 
sodium sulphite, to which it is preferred because of the greater 
proportion of sulphurous acid which it contains. Dose, gr. 
v-xx. 

Sodii Hyposulphis {Sodium Hyposulphite) (Na 2 S 2 03.5H 2 0) is 
used for the same purposes. It occurs in white, tabular crystals, 
of a pearly lustre and sulphurous taste, which are efflorescent, 
and very soluble in water and alcohol and insoluble in ether. 
Dose, gr. x-xx three times a day, and for external use, 5j dis- 
solved in water fSj. 

Potassii Sulphis {Potassium Sidphite) (K 2 S0 3 .2H 2 0) occurs in 
white, opaque fragments or powder, of a saline and sulphurous 
taste, very soluble in water ; its uses and doses are the same as 
those of sodium sulphite. 

Magnesii Sulphis {Magnesium Sidphite) (MgS0 3 .6H 2 0) is 
also employed in zymotic diseases and in flatulent dyspepsia, to 
prevent the formation of gases in the alimentary canal. It is 
less unpalatable than the sodium salt, and besides contains a 
larger proportional quantity of acid. The sodium, potassium, 
and magnesium sulphites are employed in the treatment of puru- 
lent infection. Calcium and ammonium sulphites have been also 
recommended, but are not officinal. 

The Sulphides appear to possess the power of checking the 
formation of pus. On this ground they are highly lauded in 
boils, carbuncles, etc., by Dr. Ringer. 

Calx Sulphurata {Sulphurated Lime), often misnamed Cal- 
cium sulphide, consists chiefly of a mixture of "calcium sulphide 
and calcium sulphate in varying proportions, but containing not 
less than 36 per cent, of absolute calcium sulphide." It is 
recommended to check the formation of pus, in doses of gr. I 1 c - 
every hour. In eight cases of chancroidal bubo I found the use 
of calcium sulphide of doubtful service in promoting their reso- 
lution. The dose employed was gr. \— \ t. d. (C. B.). 

ACIDUM BORICUM BORIC ACID. 

Boric or Boracic Acid (H 3 B0 3 ) exists in nature in volcanic 
regions, notably in Tuscany. In this region, which was formerly 



472 MATERIA MEDICA TOPICAL MEDICINES. 

the main source of supply of this acid, jets of steam, called 
siiffioni, escape through fissures in the hillsides, and are made 
to pass through a series of shallow basins along which water is 
slowly flowing. The water becomes charged with boric acid, 
which is converted into borax. A boiling concentrated solution 
of borax is slowly decomposed with an excess of sulphuric acid, 
and on cooling, boric acid is obtained in transparent six-sided 
crystalline plates, unctuous to the touch, odorless, slightly bitter, 
soluble in cold water, more so in alcohol and very soluble in 
boiling water. The supply to the United States is now derived 
almost exclusively from Borax Lake in California, about one 
hundred miles north of San Francisco. 

Effects and Uses. — Boric acid is antiseptic and deodorant, "arrest- 
ing fermentation and proving very poisonous to the lower forms 
of life. Neumann found by experiments on dogs, verified on 
rabbits and young pigs, that boric acid caused a decided fall in 
the temperature of the body, while large doses produced diarrhoea 
and vomiting. Three per cent, solutions injected into the serous 
cavities caused no inflammation, but when large amounts were 
injected the animal died from paralysis of the motor nerves and 
muscles.* 

According to J. Forster,f boric acid augments'the amount of 
nitrogen and of solid matter excreted by the feces, the increase 
being in direct proportion to the amount of the drug ingested. 
As small a dose as gr. vij daily will produce these effects. 

Mr. Perez % recommends the internal use of boracic acid (gr. x, 
omn. trihor.) to prevent the formation of ammoniacal urine in 
the bladder in cases of chronic cystitis. 

Mododewkow reports two fatal cases of poisoning with boracic 
acid. In one case a pleuritic cavity and in the other a lumbar 
abscess were washed out with a five per cent, solution of the acid, 
some of which remained in both cases. The symptoms were, 
persistent vomiting, hiccough, erythema beginning on the face, 
slight temporary rise of temperature, diminished cardiac power 
ending in paralysis. He suggests morphine and stimulants in 
like cases§. 

* N. Y. Me 'd. Jour., Jan. 27th, 1863, quoted from Lancet. 

f Dingl's Polytechnik Journ., No. CCLI, p. 170. 

% Lancet, July, 1884, p. 133. \ Wratch, No. 31, 1881. 



DERIVATIVES OF THE ORGANIC RADICAL PHENYL. 473 

Boric acid is used externally as an antiseptic in the treatment 
of wounds, burns, ulcers, abscesses, phlegmonous erysipelas, 
eczema, etc. It has also been used with advantage in inflamma- 
tion of the mucous membranes, as aphthae, diphtheritic inflam- 
mations of the mouth, etc. It may be dusted into the external 
auditory meatus in inflammation of that canal attended with 
suppuration, and has been used with advantage in inflamma- 
tion of the conjunctiva (gr. v-x to aq. f S j ) - Used as an injec- 
tion, it appears to shorten the duration of gonorrhoea (H. M.). 
Made into an ointment with vaseline or cerate (gr. x-xx to 5J) 
it is an excellent antiseptic dressing for wounds. 

SODII BORAS SODIUM BORATE. 

Sodium Borate or Borax occurs as a native product in several 
localities, the most important of which for a long time was 
Thibet, in Asia ; it is also made artificially by the direct combi- 
nation of native boric acid with soda. Borax (Na 2 B 4 7 .ioH 2 0) 
occurs in the form of hexahedral prismatic crystals, terminated 
by triangular pyramids, of a sweetish alkaline taste and an 
alkaline reaction. It is wholly soluble in water, slowly efflo- 
resces, and possesses the property of rendering cream of tartar 
very soluble in water. 

Effects and Uses. — Borax is a mild refrigerant and diuretic, and 
locally an antiseptic, and has emmenagogue virtues attributed to 
it. Dose, gr. xxx. 

It has been given in infantile diarrhoea as an enema, and is 
used externally in cutaneous affections (5j to water Oj as a wash 
in pruritus and in acne punctata), but especially as a detergent 
in aphthous affections of the mouth in children, mixed with an 
equal quantity of sugar. 

A piece of borax slowly dissolved in the mouth will often cure 
acute hoarseness. Glycerite of sodium borate may be made by 
rubbing up sodium borate §ij in glycerin Oss ; honey of sodium 
borate may be made by mixing 5j with clarified honey, f5j. These 
preparations are used chiefly as applications to the mouth and 
throat. 

DERIVATIVES OF THE ORGANIC RADICAL PHENYL. 

The eager search after a remedy which will replace quinine, 
has, within the last few years led to the discovery of medicinal 



474 MATERIA MEDICA TOPICAL MEDICINES. 

qualities, hitherto undreamed of, in various chemical substances, 
and this is particularly the case with regard to certain members 
of the aromatic series of the carbon compounds. While the reme- 
dies heretofore discussed under the head of antiseptics are chiefly 
used externally for their action as protoplasmic poisons, the group 
about to be studied are used internally for their antipyretic prop- 
erties, and though most of them are also antiseptic, yet the latter 
action appears to be readily modified by slight changes in certain 
members of the group. Thus, while salicylic acid is antiseptic, 
its salts do not possess this property, and its isomers — meta- and 
para-oxybenzoic acids — have no such power. 

As some knowledge of their chemical constitution is essential 
to the proper understanding of the relations existing between 
members of this group, a few remarks bearing on this subject 
will not be out of place here. 

Phenyl, the organic radical of this group, consists of carbon, 6 
atoms united with hydrogen, 5 atoms, the elements being 
arranged, according to the theory of Kekule, on which alone is 
it possible to explain the formation of its derivatives, in such a 
manner that the C. elements are united in a closed chain, exchang- 
ing with each other alternately one and two valences, and as C. 
is a tetrad, each with one exception, which is unsatisfied, is like- 
wise joined to the corresponding element H., thus — ■ 

H C H 

\ //*\ / 
C6 2C 

I II 

C5 3C 

/ \A/ \ 

H C H 

I 
H 

(PhenyL) 

Should the unsatisfied atom of C. become saturated with H., 
phenyl hydride, benzine or benzol (C 6 H 6 ) is formed. The atoms of 
H. in phenyl hydride may be displaced by other univalent 
elements or radicals and substitution compounds constructed : 
thus should one atom of H. be displaced by hydroxyl (HO), 
phenol or carbolic acid (C 6 H 5 HO) is produced ; should nitroxyl 
(N0 2 ) displace an H. atom of phenyl hydride, nitro-benzine 
(C 6 H 5 N0 2 ) results ; if amidogen (NH 2 ) replace an H. atom, aniline 



DERIVATIVES OF THE ORGANIC RADICAL PHENYL. 475 

(C 6 H 5 NH 2 ) is formed, and if carboxyl (CO HO) take the place of 
H., the product is benzoic acid (C 6 H 5 CO.OH). 

Di-derivatives containing two atoms of the same element or 
radical, are capable of three isomeric modifications, according as 
the replaced H. atoms are those numbered 1.2. or 1.3. or 1.4. in 
the above graphic formula, which isomers take the prefix ortho- 
ox meta- or para- to distinguish them ; thus, should hydroxyl 
displace 2H. atoms in phenyl hydride, one of 3 compounds may 
result — ortho-oxyphenol (/_yr<?£tf^/«Vz),meta-oxyphenol (resorcin), 
or para-oxyphenol (liydroqianone), all of which have the common 
formula C 6 H 4 (HO) 2 ; or should hydroxyl and carboxyl be the 
replacing radicals, ortho-benzoic acid {salicylic acid), meta- or 
para-benzoic acid may result, the formula for each of which is 
the same — C 6 H 4 HO.COOH. The carbon chains of the phenyl 
hydride group may join with similar chains, thus — 

H H 

H C C H 

\ // \ / % / 

c c c 

I II I 

c c c 
/ % / \ // \ 

H C C H 

A A 

(Naphthaline.) 

giving rise to a homologous series, benzene (C 6 H 6 ) being a single 
link, 2 links united forming naphthaline (C 10 H 8 ), 3 links anthra- 
cene (C 14 H 10 ), etc. 

The carbon atoms of phenyl hydride may be replaced by other 
elements ; thus, if the triad N. take the place of a C. atom in the 
chain, pyridine (C 5 H 5 N) results. The carbon chains of the ben- 
zene and pyridine groups may unite with the production of chino- 
line (C 9 H 7 N), 

H H N— H 

I I 

HCNH HCNH 



c c c c c c 

A I ■ i A I <! 



CCH HCCHH 

II I l\ 

H. H K H H 

(Chinoline.) (Chinocine or Quinocine. 



476 MATERIA MEDICA — TOPICAL MEDICINES. 

or by a modification in the arrangement of valences of the pyri- 
dine link in chinoline, it is enabled to unite with more H. and N., 
forming chinocine or quinocine (C 9 H 10 N 2 ), and from these are 
obtained several important salts, as Kairin (oxyethyl-chinoline 
hydride hydrochlorate), thatlin (tetrahydroparamethyloxychino- 
line) and antipyrine (dimethyloxychinocine). 

Phenyl hydride, benzine or benzol is only of interest in medicine 
from a toxicological point, several cases of poisoning from it having 
been reported,* and from the fact as shown by Filehne,f that its 
derivatives, benzyl-tropine, benzyl-quinine, etc., are local anaesthet- 
ics of considerable power. 

ACIDUM CARBOLICUM CARBOLIC ACID. 

This substance, termed also phenol, phenic acid, or phenyl 
hydrate, is a product of the distillation of coal-tar oil. 

Crude Carbolic Acid (Acidum Carbolicnm Crudmn) is made 
by treating the impure coal-tar of commerce with a saturated 
solution of potash, when it is resolved, on the addition of water, 
into a light oil and a heavier alkaline liquid ; the latter is sepa- 
rated and neutralized with hydrochloric acid, and the impure 
carbolic acid, which is disengaged, is afterward distilled from 
dried calcium, to remove water, when upon exposing the distil- 
late to a low temperature, carbolic acid congeals in the form of a 
colorless crystalline mass. 

In its pure state it is solid at ordinary temperatures, crystal- 
lizing in long rhomboidal needles, white or colorless, of a pecu- 
liar empyreumatic odor like unto (but not identical with) that of 
creasote, and an acrid, burning taste ; if even slightly impure, it 
has a reddish color, or will acquire it on exposure. Its sp. gr. 
is 1.065 ; it deliquesces readily and assumes the liquid state in 
the presence of a little water, without dissolving in it. 

When quite pure it melts at 160 F., forming an oily-looking, 
colorless liquid, which boils at 359 F. It is soluble in 20 parts 
of water, and very soluble in alcohol, ether, acetic acid, glycerin 
(commercial and absolute) and in the fixed and volatile oils. 

* Annates cP Hygiene, 1 883, p. 426, MM. Neumann et Pabst. 
f Berlin Klin. Wochensch., No. 7, 1 887. 



ANTISEPTICS AND ANTIPYRETICS CARBOLIC ACID. 477 

Carbolic acid may be recognized by the following tests : " 1st, 
by its peculiar smell ; 2d, by the formation of yellow picric acid, 
with nitric acid of 36 B. ; 3d, by the production of a blue or green 
color when treated with a small quantity of ammonium hydrate 
and a trace of a solution of a hypochlorite " (Salkowski's test) ; 
4th, by a lilac color produced on the addition of a small quantity 
of ferric sulphate; 5th, by a yellowish-white precipitate with 
bromine water " (Witthaus *). 

The last three tests are very delicate. 6th. The most delicate 
test is that suggested by Plugge : " When a liquid containing 
carbolic acid is boiled with a little solution of mercurous nitrate 
containing a trace of nitrous acid, a reduction of the mercurous 
salt takes place and the liquid becomes of an intensely red color." 
This test is said to detect 1 part of carbolic acid in 200,000. 
Carbolic acid in solution coagulates albumen and precipitates 
nitro-cellulose from collodion, which distinguishes it from creasote. 
Although it combines with salifiable bases, it does not act as an 
acid upon colors, and is chemically phenyl hydrate (C 6 H 5 HO). 

Physiological Effects. — Carbolic acid is a protoplasmic poison, 
destructive to all forms of life, whether vegetable or animal. 
When applied to the skin it produces a white superficial eschar, 
becoming brownish. When applied in a concentrated form it 
causes very great local anaesthesia, extending inward for some 
depth to the tissues with which the acid has not come in con- 
tact. Nervous system : after poisonous doses have been given 
to animals, there is paralysis of the posterior extremities, extend- 
ing to the anterior, and finally reflex tetanic convulsions. In 
man a poisonous dose produces vertigo, contracted pupils, and 
stupor with sometimes tremors, never, however, amounting to 
convulsions, as in the lower animals. The convulsions are prob- 
ably of spinal origin — certainly not peripheral. The reflex 
activity is at first increased, then abolished. The nerves and 
muscles are not paralyzed, but after death they are found to be 
more readily exhausted than normal. Circulation : the heart is 
at first depressed, afterwards accelerated (caused by stimulation 
and exhaustion of the vagi). In slow cases of poisoning, death 
is produced by diastolic arrest. The arterial pressure is reduced 

* " General Med. Chemistry." By R. A. Witthaus, A. M., M. D. 



478 MATERIA MEDICA TOPICAL MEDICINES. 

on account of the paralysis of the vaso-motor centre of the cord. 
Dr. Prudden* has shown that in strong solution it paralyzes, 
while in weak solution it renders sluggish, the movements of the 
white corpuscles in frogs. Carbolic acid probably enters the 
blood as an alkaline carbolate. Respiration is affected early in 
the poisoning, the movements being much increased in frequency 
but very shallow ; this increase is due to stimulation partly of 
the peripheral vagi and partly of the respiratory centre (Salkow- 
ski). Temperature is somewhat reduced. Elimination takes 
place by all the secretions, especially by the urine, saliva and 
breath. When a small amount only is taken, it is probably ail 
excreted as an alkaline carbolate ; but when the amount is larger, 
a portion is oxidized in the system and escapes under different 
forms, especially as oxalic acid in the urine. These products of 
oxidation generally color the urine dark brown or black, and as 
this is one of the first signs of poisoning, the urine should always 
be watched when carbolic acid is being administered or when 
it is applied to a large surface. 

Andersonf reports a case in which 5j of the pure acid killed 
an adult in twelve hours, with symptoms of acute gastritis ; and 
HearderJ one in which a man died in thirty minutes after swal- 
lowing oj. The external application, too, of carbolic acid has 
destroyed life. 

Post-mortem appearances : after death from a concentrated 
solution of the acid, hard, white, dry spots surrounded by a 
circle of inflammation are found on all the mucous membranes 
with which the acid comes in contact, even as far down as the 
intestines in some instances. All the viscera are filled with dark, 
imperfectly-coagulated blood, and sometimes there is fatty degen- 
eration of the liver and kidneys. 

As a chemical antidote in cases of poisoning a saturated solu- 
tion of calcium saccharate has been recommended. Atropine is 
the physiological antagonist of carbolic acid ; enough should be 
given to counteract the depressing effect of the acid upon the 
respiration and circulation, and diluents should be freely admin- 
istered to aid in its elimination (A. C. Post). 



* Amer. Jour. Med. Sci., Jan., 1881. f The Lancet, Jan. 1869, p. 179. 

%Brit. Med. Jour., May, 1873, P- 5 8 4~ 



ANTISEPTICS AND ANTIPYRETICS^CARBOLIC ACID. 479 

Medicinal Uses. — Carbolic acid is used internally to check 
vomiting, as an astringent in diarrhoea, in sarcina ventriculi, as 
an anthelmintic, and in zymotic diseases, as smallpox, typhoid 
fever, scarlatina, erysipelas, diphtheria, etc. It has also been 
given internally with some success in cholera, cholera morbus 
and diabetes of hepatic origin. In phthisis and gangrene of the 
lungs it has been found of service, and combined with iodine in 
chronic malarial poisoning it is highly recommended. Carbolic 
acid spray is used as an inhalation in chronic nasal catarrh, hay 
asthma, chronic bronchitis, whooping cough, phthisis, gangrene 
of the lungs, etc., with a view of destroying germs, stimulating 
the mucous membrane to healthy action and correcting fetor. 
Deep-seated injections into the tissues of a two per cent, solution 
of carbolic acid, as recommended by H titer, have been practiced 
with success in erysipelas (Aufrecht), abscesses, etc., and are 
thrown into the cavity of joints in synovitis, and into bursae in 
ganglion, etc. Extraordinary care must be taken not to inject 
the acid into a blood-vessel. 

Dr. R. J. Levis injects pure carbolic acid (the crystals liquefied 
by heat) 5ss-j into the sac of the tunica vaginalis after evacuating 
its contents, for the radical cure of hydrocele. This treatment is 
followed at the Out-Patient Surgical Department of the Jefferson 
College Hospital with almost unvarying success. Dr. S. W. 
Gross * has collected 90 cases of hydrocele treated by the car- 
bolic-acid method, all of which were successful, though suppura- 
tion ensued in three. 

As an external application its uses are still more important. It 
is employed in the concentrated form as a caustic in condylomata 
lupus, etc., and to produce local anaesthesia for minor surgical 
operations, as opening abscesses, felons, etc., and in various forms 
of dilution as an application in diphtheria, in cutaneous eruptions 
(especially those of organic origin), as a dressing to foul ulcers, 
abscesses and sinuses, to compound fractures, to carbuncles, to 
burns and scalds, to suppurating surfaces with a view to the pre- 
vention of pyaemia, and, from its influence in coagulating albumen, 
as a hemostatic. Under the belief that carbolic acid destroys 
the organic floating germs which produce inflammation and sup- 

* Med. Times, April, 1 888, p. 384. 



480 MATERIA MEDICA TOPICAL MEDICINES. 

puration upon wounded surfaces, washings and dressings with 
solutions of this acid (1 part to 40 parts of water) have been much 
employed, as first suggested by Sir J. Lister, of Edinburgh. It 
is also a most valuable disinfectant. 

The dose, internally, is gr. j-ij or, if liquefied by heat, gtt i-ij, 
in sweetened water or glycerin. For disinfectant purposes, the 
crude liquid acid (which contains from 70 to 90 per cent, of 
carbolic and cresylic acids jointly, with impurities derived from 
coal-tar) answers very well. Sodium and potassium carbolates 
have been also employed. Ointment of carbolic acid (unguentum 
acidi carbolici) contains 10 per cent, of carbolic acid in ointment. 

Sodii Sulpho-carbolas {Sodium Sulpho-carbolate) (NaC 6 H 5 - 
S0 4 .2H 2 0) is a colorless, transparent salt occurring in rhombic 
prisms, permanent in the air, soluble in about 5 parts of water, 
and also in glycerin and alcohol. It is obtained by adding sodium 
carbonate to a solution of barium sulpho-carbolate, previously 
obtained by adding barium carbonate to sulpho-carbolic acid 
(made by dissolving one part of crystallized carbolic acid in an 
equal amount by weight of strong sulphuric acid — C 6 H 5 HO -f- 
H 2 S0 4 == C 6 H 5 HS0 4 + H 2 0), and stirring until effervescence 
ceases and then filtering. 

Potassium, magnesium and calcium sulpho-carbonates have 
also been employed ; they may be given as antiseptics in cholera 
and zymotic diseases generally. They are recommended as 
excellent topical applications to inflamed mucous membranes, 
and good results have attended their use in tonsillitis, aphthae 
of children, catarrh of the nares and gonorrhoea. Sodium sulpho- 
carbolate is a good remedy for flatulence ; dose, gr. x— xv. The 
lead sulpho-carbolate might be used where the lead acetate is 
indicated and the corrective action of carbolic acid is called for, 
while its solubility in glycerin and alcohol adapt it to external 
application. 

CREASOTUM CREASOTE. 

Creasote is a complex substance obtained from wood-tar by 
dry distillation, or from crude pyroligneous acid ; the best is 
made from beechwood-tar. It contains phenol (C 6 H 5 HO), cresol 
(C 6 H 4 (CH 3 )HO), creasol (C 8 H 10 O 2 ) and other substances obtained 
from wood-tar. When pure it is a colorless, oleaginous liquid, 



ANTISEPTICS AND ANTIPYRETICS CREASOTE. 48 I 

with a caustic, burning taste and a penetrating, disagreeable, 
characteristic odor, like that of smoked meat. Its sp. gr. (U. S. P.) 
is 1.035-1.085, but when pure is 1.080. After exposure to light 
for a long period it becomes wine-yellow ; if it turn red, it is not 
fit for medicinal use. It forms two solutions with water, one of 
1 part to 80 parts of water, the other of 1 part to 10 parts of 
creasote ; and it is soluble, in all proportions, in alcohol, ether, 
naphtha, and glacial acetic acid. Crude phenol is often substi- 
tuted for creasote ; the latter may be distinguished by its insolu- 
bility in commercial glycerin ; by not precipitating nitro-cellulose 
from collodion when mixed with it ; by giving a green color with 
ferric chloride and alcohol (phenol gives a brown color) and by 
giving a green color passing to brown with ferric chloride and 
ammonium hydrate (phenol giving a violet color) (Witthaus). A 
remarkable property of creasote is its power of preserving meat, 
whence its name (from xp£as } flesh, and <rd>^uj, I save). 

Effects and Uses. — Creasote possesses many properties in com- 
mon with carbolic acid. It is eliminated by the bronchial mucous 
membrane (which it stimulates as it passes out, and hence is a 
good expectorant), by the kidneys, etc. It is not much used, 
because of the difficulty of procuring the pure drug. In large 
doses it is an acro-narcotic poison, resembling carbolic acid, but 
with more marked nervous symptoms. In cases of poisoning 
from creasote the same treatment is to be resorted to as in 
poisoning by carbolic acid. 

In small doses it is styptic and astringent, and, though not 
very nearly allied to the vegetable astringent articles which con- 
tain tannic acid, it is, perhaps, more generally administered for 
its astringent than for any other properties. It is an excellent 
remedy in hematemesis, and is also employed in hemoptysis and 
other hemorrhages. It is very efficacious in allaying vomiting 
and gastric irritability, and has been exhibited for its astringent 
virtues with good effect in diarrhoea, diabetes and chronic bron- 
chitis, and as a nervine in epilepsy, hysteria, neuralgia, etc. 

Externally it is applied in various degrees of dilution, to indo- 
lent, sloughing and foul ulcers, and as a gargle in putrid sore 
throat. In the concentrated form it is a good styptic in capillary 
hemorrhages, and is applied with effect to the hollows of carious 
teeth, for the removal of the pain of toothache. 
31 



482 MATERIA MEDICA TOPICAL MEDICINES. 

Dose, internally, ^j-iij, frequently repeated, in pill or diluted 
with mucilage. 

For external use, from gtt. ij-vj, or more, may be added to 
fSj of distilled water. 

Aqua Creasoti {Creasote- Water) (1 part to distilled water 99 
parts). It may be used locally as a slightly stimulating lotion, 
or mixed with poultices to correct fetor. Internally it is a con- 
venient form of administration. Dose, f5i-iv. 



Nitro-benzine is an important agent in aniline industries, being 
used in the manufacture of the latter for commercial purposes. 
It is not used in medicine, but is interesting on account of the 
numerous cases of poisoning which have occurred from its use in 
perfumery (in which it is known as the " Essence of Mirbane ") 
and to impart the flavor and smell of bitter almonds to articles 
of food or beverages. It has also been taken by mistake for a 
liqueur* The proper treatment of poisoning by this substance 
is prompt evacuation of the contents of the stomach if it has 
been swallowed, artificial respiration, and blood-letting followed 
by transfusion. 

Aniline is used especially in the manufacture of brilliant dyes. 
Numerous cases of poisoning are on record from the ingestion 
of confectionery, etc., colored by this means. 

Prof. Kremianski recommended it highly in the treatment of 
phthisis, but the committee appointed to investigate the subjectf 
and other experimenters^ have not obtained like results. The 
various aniline-colors are used in medicine as reagents in stain- 
ing bacilli for microscopic examination. It is also interesting as 
being the base of aniline acetate, from which antifebrin, one of 
the latest and most powerful antipyretics, is obtained. 

ACETANILIDE. 

Acetanilide or Antifebrin (C 6 H 5 NH.COCH 3 , — not officinalis a 
neutral chemical product, prepared by heating aniline with crys- 

* Deutsche milit.-arztl. Zeitung, II, 1873. f Vratch, No. 10, 1887, p. 241. 

\ Vratch, No. 4, p. 91 and 13, p. 288, 1887. 



ANTISEPTICS AND ANTIPYRETICS ACETANILIDE. 483 

tallizable acetic acid in a special receptacle, distilling the product 
and purifying by successive crystallizations, and consists of aniline 
acetate from which the elements of water (H 2 0) have been 
separated by a dialytic action at an elevated temperature (Merck). 

It is a very stable compound, resisting the action of acids and 
alkalies at ordinary temperatures, and occurs in the form of a 
white crystalline powder, odorless, having a slightly sharp, but 
not disagreeable taste, almost insoluble in cold water (i to 160 
parts), but easily soluble in boiling water (i to 25 parts), alcohol 
($y 2 ) and ether (6). 

Effects and Uses. — The most important effects of this drug are 
the rapid lowering of febrile temperature and the power which it 
possesses of moderating the activity of the nerve-centres. 

As an antipyretic it is four times more powerful than antipyrine, 
causing a reduction of temperature within an hour after its 
administration, the minimum being attained in from three to five 
hours, followed at first by a slow and then a more rapid rise until 
the temperature reaches its original height, or even a little 
beyond it, in from three to twelve hours.* This action is more 
marked when the temperature is very high,f and when the medi- 
cine is so administered that the artificial reduction will take place 
coincidently with the natural subsidence: thus its effects are 
greater when given in the morning. More or less profuse per- 
spiration occurs during the reduction of the body-heat, and the 
succeeding rise is sometimes preceded by a rigor. 

From extensive and careful experiments with acetanilide, 
thallin or antipyrine, Pasternatzky J concludes that from five to 
ten minutes after taking either of these substances, the internal 
temperature diminishes while the cutaneous temperature rises, 
and the heat given off by radiation is increased in direct propor- 
tion to the elevation of the cutaneous temperature, although the 
maximum elevation is attained earlier than the maximum loss of 
heat, and that the sweating coincides with the latter. During the 
second hour the internal temperature continues to fall, but with 
more intensity ; the cutaneous temperature gradually subsides, 



* Centralbl. f. Klin. Med., No. 33, p. 1561. Cahn und Hepp. 
f Deutsche Med. Wochensch., No. 16, 1887. 
% Vratek, No. 2, p. 21 ; No. 4, p. 70, 1887. 



484 MATERIA MEDICA TOPICAL MEDICINES. 

and the loss of heat by radiation and the sweating diminish in 
direct proportion to the decline of the latter. Therefore, not only 
do they lower temperature, but they also balance the distribution 
of caloric in the system. They are antipyretic, by restraining 
nitrogenous metamorphosis, by limiting heat-production, and 
also by regulating the heat-distribution of the economy. These 
effects are only seen in a condition of pyrexia. As the tem- 
perature falls the pulse becomes slower and stronger and the 
arterial tension is heightened. Acetanilide impairs temporarily 
the oxygen-carrying function of the red corpuscles, by lessening 
the oxy-hemoglobin and forming with it methy-hemoglobin, as 
is shown by the cyanosis which is sometimes observed, but this 
condition quickly passes away as the normal condition of the 
blood is restored. 

Gastric or intestinal disturbance is of rare occurrence, while 
renal irritation never results, although the amount of urine is 
sometimes considerably augmented ; and lastly, the elimination 
of urea is diminished*. 

In decided doses, acetanilide lowers the activity of the reflex 
centres, and reduces the conductivity of the motor and sensory 
nerves, probably to a great extent through its influence on the 
bloodf. An inclination to sleep accompanies this anodyne action. 
If given in lethal doses J (gr. v-x per kilo, of weight of animal), 
the effects are manifested primarily upon the constituents of the 
blood and then on the nervous system ; afterward general pros- 
tration with stupor ensues and the temperature is rapidly and 
progressively lowered. Sensation is first diminished and then 
lost ; the animal sinks into a comatose condition, followed by 
spasmodic convulsions, and dies in from 24 to 36 hours. The 
heart is at first accelerated then slowed, and the respiratory func- 
tions are markedly and progressively depressed. 

Acetanilide is chiefly used as an antipyretic and as an anodyne ; 
For the former purpose it is probably more generally employed 
at the present time than any other agent of this group, although 



* Russ. Meditz., No. 43, 1886, p. 728. A. Berezovski. 

f Comptes Rendus de la Soc.de Biol., Juillet iieme, 1887. M. Lepine. Rev. 
Med. de la Suisse Romande, Juin, 1887. M. Demieville. 
\Bull. Gen. de Therap., Fev. 28iem e> 1887. Dr. Weill. 



ANTISEPTICS AND ANTIPYRETICS BENZOIC ACID. 485 

some observers * regard antipyrine as safer, fearing the cyanosis, 
tendency to collapse, and severe rigors which occasionally attend 
its action. 

In all cases of high temperature, notably in typhoid fever, 
phthisis, scarlatina and rheumatism, it may be given in small 
doses, repeated as required, with excellent effect. 

In acute rheumatism it not only reduces the temperature, but 
also is said to act on the joints in as favorable a manner as do the 
salicylates. In croupous pneumonia and in chronic catarrhal 
pneumonia, it has been used with advantage. 

It is used as an anodyne in the pains of various nervous dis- 
eases, especially those of locomotor ataxia; also in neuralgia, 
particularly of the fifth pair of cranial nerves ; in headaches 
of various kinds not depending on indigestion, and in dysmenor- 
rhea. 

In epilepsy it diminishes the violence and frequency of petit 
mal, but does not seem to influence grand mal. 

Administration. — -The dose of acetanilide ranges from gr. iv- 
viij, though much larger quantities have been taken with safety. 
It is best administered in capsules or in powder, as it diffuses 
readily into the blood in spite of its insolubility. 

ACIDUM BENZOICUM BENZOIC ACID. 

Benzoic Acid (HC 7 H 5 2 ) is obtained from benzoin by subli- 
mation, or by the action of alkalies ; it is also made in Germany 
from hippuric acid. As obtained by sublimation, it occurs in 
white, soft, feathery hexagonal crystals, of a silky lustre, and not 
pulverulent. It has more or less of the agreeable odor of the 
balsam, a warm, acrid and acidulous taste, is inflammable, 
sparingly soluble in cold water, .rather soluble in boiling water, 
but perfectly soluble in alcohol, alkaline solutions and fixed oils. 
It is a constituent of the balsams. 

Effects and Uses. — Benzoic acid is a local irritant, destroying 
minute organisms, possessing decided antiseptic properties, and 
acting on the general system as a stimulant, with a particular 
direction to the mucous surfaces. In large doses it increases the 
circulation and respiration, and is said to be a more powerful 

* Comptes Rendus de V Acad, des Sciences, Avril i8ieme ? 1887. GermainSee. 



486 MATERIA MEDICA TOPICAL MEDICINES. 

antipyretic than salicylic acid. It stimulates the cutaneous and 
bronchial secretions, and increases the acidity of the urine. In 
its passage through the system it abstracts nitrogen from the 
elements of urea, and passes out with the urine in the form of 
hippuric acid ; hence its value in uraemic poisoning, and in the 
treatment of ammoniacal urine. 

It has been used in diphtheria, erysipelas, etc., with a view to 
its antiseptic effects, and as an expectorant in chronic bronchial 
affections. Locally, it is employed as a dressing for wounds, 
ulcers, etc., and to prevent animal fats from becoming rancid. 
Dose, gr. v-xx. 

Sodii Benzoas (Sodium Benzoate) (NaC 7 H 5 02.H 2 0) is a white 
amorphous powder, which effloresces on exposure to the air, and 
has a faint odor of benzoin and a sweetish, astringent taste. It has 
been prescribed as a substitute for salicylic acid, being less pow- 
erful as an antipyretic, but is a safer remedy. It has been used 
extensively in phthisis, with a view to its antiseptic qualities ; also 
in diphtheria, scarlet fever and the eruptive fevers generally, 
whooping-cough, etc. ; and in acute rheumatism as an antipyretic. 
From 5j-iij may be given in twenty-four hours. 

Ammonii Benzoas (Ammonium Benzoate) (NH 4 C 7 H 5 2 ) is 
made by adding water of ammonia to an aqueous solution of 
benzoic acid, and occurs in the form of minute white, shining, 
thin, four-sided laminar crystals, with a slight odor of benzoic 
acid and a bitterish, saline, somewhat balsamic taste and slightly 
acrid but persistent after-taste. It is soluble in water and alcohol, 
and, when heated, sublimes without residue. It is incompatible 
with the ferric salts. 

This salt, when taken internally, is probably decomposed by the 
gastric acids, and produces the constitutional effects of benzoic 
acid, for which it may be substituted ; the ammonia renders it 
stimulant and antacid, and acceptable to irritable stomachs. It 
is an excellent remedy for incontinence of urine due to the irri- 
tation produced by an alkaline condition of that fluid, and is used 
with advantage whenever the urine is ammoniacal and loaded 
with phosphates. Dose, gr. v-xx. 



ANTISEPTICS AND ANTIPYRETICS RESORCIN. 487 

RESORCIN. 

Resorcin (not officinal), chemically meta-oxyphenol, derives 
its name from having been first obtained from certain resins by 
the action of alkalies, and from bearing some resemblance to 
orcin. 

It occurs as shining tabular crystals, having a slightly phenol- 
like odor and a sharp-sweetish taste, soluble in most liquids, 
especially in water. 

Effects and Uses. — Locally it is an antifermentative and anti- 
putrefactive agent, destroying the organisms on which these 
processes depend. Internally, like other agents of this group, 
resorcin promptly reduces febrile temperature when administered 
in medicinal doses, but it does not seem to affect the temperature 
in healthy individuals, as Dr. Justus Andeer, experimenting upon 
himself, took as much as 10 grammes without observing a 
reduction of body-heat. 

The antipyretic action is more marked in typhoid fever, 
pneumonia and erysipelas than in other febrile states, although 
it is present to some extent in malaria, and indeed it appears to 
possess some antiperiodic -power, as might be inferred a priori 
from the close chemical relationship which it bears to quinine, 
to which, however, it is very far inferior in this respect. It is 
well borne by the stomach. The decrease in the temperature of 
fever is usually preceded by transient vertigo, tinnitus aurium, 
flushing of the face, headache, and oppression in the chest. As 
the temperature declines there is nearly always a profuse per- 
spiration, and the pulse and respiration, which were at first 
accelerated, are markedly slowed. This occurs in about one 
hour after the ingestion of the drug and continues for from two 
to four hours, and is then followed by a more or less well-marked 
chill and a gradual rise in temperature. 

When a large dose is given to an animal, trembling supervenes, 
soon followed by general epileptiform convulsions, each occupy- 
ing a few minutes only, which regularly increase in severity, 
reach their maximum and as regularly decline. The general 
sensibility is not affected. The convulsions appear to be of 
spinal origin. The pulse is weak, rapid, and irregular, the 
breathing accelerated, convulsive, then shallow and weak, and 
finally death takes place from failure of respiration, preceded by 



488 MATERIA MEDICA TOPICAL MEDICINES. 

a rise in temperature from excessive muscular action. Elimina- 
tion takes place rapidly, chiefly through the urine. 

Internally. — As an antipyretic, resorcin has been used in typhoid 
fever, pneumonia, erysipelas, rheumatism, and septicaemia. It 
has also been used in malaria, especially in the intermittent form, 
and is said to diminish recent splenic tumefaction, and to antago- 
nize malarial infection (Righi*). 

As a sedative and antifermentative it is used in acute gastro- 
intestinal catarrh, gastralgia and dyspepsia due to fermentation 
of the ingesta, for which purpose it may be advantageously com- 
bined with sodium bicarbonate. Locally it has been applied as 
an antiseptic to unhealthy ulcers and wounds, to destroy fetor 
and promote healthy granulations. 

Unna recommends a 5 or 10 per cent, ointment in pityriasis 
capitis, squamous eczema of the head and in seborrhceal eczema. 
In psoriasis an ointment of the strength of 10 to 20 per cent, 
may be used with advantage.- The powder or a strong ointment 
may be applied in parasitic sycosis with marked benefitf. 

According to Dr. Jackson^, it is very useful in epitheliomatous 
lesions where surgical interference is contra-indicated, as it exerts 
a powerful absorptive effect on new cell-infiltrations. Pure resorcin 
has also been powdered on condylomata of the penis, vulva or 
anus with brilliant results§. It is also used in solution of various 
strengths in various diseases of the mucous membranes, as in 
acute or chronic conjunctivitis; as a disinfectant, antiseptic, and 
in strong solutions, as a caustic in laryngeal diseases. In tuber- 
cular ulceration of the larynx, the pain soon subsides, and the 
cough diminishes after these applications. 

In gleet a 2 per cent, solution may be injected into the urethra 
with excellent effect (Dr. Justus Andeer||, Righi, op. cit.). 

Administration. — The ordinary dose is gr. v-xv, either in cap- 
sules or in solution in alcohol, glycerin or water, disguised with 
syrup of orange-peel. These doses may be repeated every four 



* El Siglo Medico, Mar. 9, 1884. 

f Centralbl.f. die ges. Therap., Mar. 1886, Ihle. 

% Journ. Cutan. and Genit.- Urin. Diseases, Vol. V, Nos. 6 and 7. 

\ Russ. Meditz., No. 38, 1886, p. 639, Gatchovsky. 

|| Centralbl. f. die gesammte Therap., Apr. 1 884. 



ANTISEPTICS AND ANTIPYRETICS RESORCIN. 489 

hours. Much larger amounts have been taken without producing 
injurious or alarming symptoms. 



Hydroquinone or Hydrochinone (para-oxyphenol) and Pyro- 
catechin (ortho-oxyphenol), neither of which are officinal, are 
isomers of resorcin, as has already been pointed out. Their 
effects are identical with those of the latter, than which they are 
about four times as powerful. They are little used, being super- 
seded by acetanilide and other antipyretics of more recent date, 
although, by some*, hydroquinone is thought to be among the 
most powerful and least harmful remedies of this group. 

ACIDUM SALICYLICUM SALICYLIC ACID. 

This acid, although known for nearly half a century as a 
derivative of salicin (see p. 154), has been employed only recently 
as an article of the Materia Medica. It has been prepared from 
the flowers of Spircea ulmaria or Meadozv- Sweet, and from the 
oil of gaultheria (where it exists as methyl salicylate), and by the 
oxidation of salicin. It is now made by combining pure carbolic 
acid with caustic soda, and treating this compound with dry car- 
bonic acid under the influence of a gradually-increasing heat, 
when one-half of the carbolic acid distils over, while the other 
half, into the molecule of which carbonic acid enters, remains 
behind as sodium salicylate ; from a hot aqueous solution of this, 
saturated with hydrochloric acid, salicylic acid (C 6 H 4 {3ooh}) is 
obtained in the form of minute, broken, acicular crystals (having 
usually the appearance of a pale-pinkish granular powder), which 
are bleached with great difficulty. 

It is odorless and nearly tasteless, having, however, a sweet 
and astringent after-taste, with slight acridity in the fauces. It 
is practically insoluble in cold water, but quite soluble in boiling 
water, a hot aqueous solution retaining when cold, in proportion 
to its coldness, 1 part in from 250 to 500 parts of the solution. 
The addition of 2 parts of sodium sulphite, or 1 part of ammo- 
nium phosphate, or 3 parts of sodium phosphate, renders it much 
more soluble in water. It is freely soluble in alcohol, ether and 
( . , 

* Berliner Klin. Woc/iensck., No. 29, 1884, Dr. P. Seifert. 



490 MATERIA MEDICA TOPICAL MEDICINES. 

glycerin. Dissolved in water, a fine violet color is produced on 
the addition of ferric chloride. 

Physiological Effects. — In its effects salicylic acid is allied to 
carbolic acid, possessing probably greater powers as an antiseptic 
in arresting the putrefactive and fermentative processes, while it 
is devoid of smell or notable taste, is not volatile, and is also, in 
quantities necessary for effective action, free from irritant or 
poisonous influence. When given internally in full medicinal 
doses buzzing and roaring in the ears, with fulness in the head, 
are experienced, which are much increased after the administra- 
tion of larger doses, amounting even to deafness and accompanied 
by headache and partial blindness. If an excessive dose be taken 
all the symptoms are intensified, and great restlessness, followed 
by delirium, involuntary evacuations, stupor, and in the lower 
animals convulsions, are observed. The action of salicylic acid 
upon the ear (as well as the similar action of quinine) has been 
investigated with varying results. Kirchner concludes that these 
remedies produce intense congestion of the tympanum and laby- 
rinth (due to vaso-motor disturbance), which may lead to changes 
in the nerve-filaments ; while Weber-Liel and Guder * found 
anaemia of these parts as the result of the ingestion of the drug. 

The heart-beat is at first increased in frequency, but afterward 
slowed ; excessive doses cause the pulse to become slow and 
labored. The blood-pressure is at first elevated (from the action 
of the acid on the heart and on the vaso-motor centres), then 
lowered. Blood : Prudden,f from experiments upon frogs, veri- 
fied on rabbits and on the human blood, concludes that salicylic 
acid restrains the migration, and in strong solutions is inimical 
to the life, in weak solutions to the activity, of the white blood- 
corpuscles. Respiration is at first quicker and deeper than nor- 
mal from the action of the drug on the vagi and to some extent 
on the respiratory centre ; later it becomes slow and labored, and 
death results from asphyxia. Temperature : non-toxic doses 
have little or no effect upon the normal temperature ; in fever, 
however, salicylic acid causes a marked reduction in the body- 
heat which lasts for several hours. Secretion : full doses cause 
free diaphoresis which is sometimes exhausting. The urine is 

* Med. Rec, Oct. 28th, 1882. f Am. Jour. Med. Sc, lxxxii, 1882. 



ANTISEPTICS AND ANTIPYRETICS RESORCIN. 49 1 

sometimes increased, sometimes diminished, and often contains 
albumen. It somewhat increases the secretion of milk, and the 
amount of sugar in that secretion seems to be augmented*. 
Gastro-intestinal tract : large amounts cause nausea and often 
vomiting. Absorption and elimination: it is probably absorbed 
as a sodium salicylate, and is eliminated principally by the urine 
partly unchanged, and partly as salicyluric and (possibly) oxalic 
acids. Elimination takes place slowly. After the ingestion of 
large quantities the urine will be colored green from an increase 
of the indican. 

Medicinal Uses. — For its antipyretic effect salicylic acid has 
been used in fevers with varying success. In acute rheumatism, 
especially in robust patients, it is preeminently of value, reducing 
the temperature, relieving the joint affection and ameliorating the 
pain; but whether it shortens the duration and decreases the 
frequency of cardiac complications and relapses is still disputed. 
In rheumatic hyperpyrexia it is of value, but should not be 
relied on to the exclusion of other means of reducing tempera- 
ture. In gonorrhceal rheumatism and gout, where no kidney 
complication exists, it is also of service, and has been recom- 
mended in typhoid and eruptive fevers, pyaemia, puerperal fever, 
diphtheria, etc.; although not as effective in these diseases as in 
rheumatism, and, indeed, it has been condemned by some as being 
of no avail. It is strongly recommended in acute tonsillitis in 
doses of gr. x every two to four hoursf. As an antizymotic to 
prevent fermentation of the ingesta its use is advised in gastric 
catarrh, gastric dilatation, sarcina and allied complaints. As an 
anthelmintic salicylic acid has been used with success against 
tape-worm, and also internally and locally against ascarides. 
Externally it has been used in the moist stages of eczema and 
eczema rubrum with good results. 

As a detergent and desiccant it may be sprinkled dry on 
wounds or ulcers in the form of powder, or mixed in various 
proportions with some inert powder, as starch ; or a solution, I 
part to 300 parts of water, may be used as a substitute for the 
antiseptic carbolic dressing ; the stronger solution with sodium 



* Deutsches Arch. f. Klin. Med., Jan., 1882, Dr. Max Stumpf. 
f Brit. Med. Jour., Oct. 14th, 1882, Dr. Edward Mackey. 



492 MATERIA MEDICA TOPICAL MEDICINES. 

phosphate, I part to 50 parts of water, is used to wash or spray 
foul surfaces, or as an application in diphtheria; a solution of 
gr. j to f oj of water is a good injection in gonorrhoea and col- 
lyrium in conjunctivitis. Dose, gr. x-5j. The following solu- 
tion makes an excellent application to inflamed or painful corns : 
Tfy Acidi salicylici, gr. x ; collodii flexilis, fSj. M. Whether 
employed internally or externally it passes rapidly into the 
urine, and gives with ferric chloride a blue or violet reaction. 
The acid retains its antiseptic properties only so long as it remains 
in a free state. 

Sodii Salicylas {Sodium Salicylate) (2NaC 7 H 5 3 ,H 2 0) is a 
white crystalline powder, without smell, having a sweetish alka- 
line taste. 

Internally its effects and uses are identical with those of sali- 
cylic acid, to which it is preferred, because it is more soluble in 
water and causes less gastric irritation. 

Dr. Gasparini * employs it in pleurisy when diaphoretic treat- 
ment is indicated. 

Locally it is recommended in solution (sodium salicylate, 5ij ; 
laudanum, f5ij ; water, fSviij) to relieve the suffering caused by 
gouty hands and feet, and rheumatic jointsf . 

Dr. Baudon anoints the surface three times a day, in variola, 
with sodium salicylate, 5j ; in cold cream, oj ; and claims that it 
lessens the suppuration and removes the odor. 

Lithii Salicylas {Lithium Salicylate} is also officinal, and is 
used internally to fulfill the indications of salicylic acid. The 
salts are given in doses corresponding to those of the acid. 

SALOL. 

Salol (not officinal) is an ether-combination of salicylic acid, 
60 per cent., and carbolic acid, 40 per cent. It is not a salicylate 
of phenol, as has been erroneously stated in some quarters, but a 
salicylic-phenol-ether, and occurs as a white powder, tasteless, 
having a faint odor resembling carbolic acid, slightly unctuous to 

* Gaz. Med. ItaL, Lombard, March, 1885. 

f Brit. Med. Jour., Oct. 14th, 1882, Dr. E. Mackey. 



ANTISEPTICS AND ANTIPYRETICS SALOL. 493 

the touch, insoluble in water, but easily soluble in alcohol, in 
ether and in the fixed and volatile oils. 

Effects and Uses. — It is an antiseptic, not a germicide, for, like 
iodoform, it will prevent the formation of bacteria, but will not 
destroy them when actually present (Nencki). Locally, as it is 
insoluble, it does not irritate the skin nor the surface of wounds 
when applied to them, and hence may well replace iodoform in 
local antisepsis. When administered internally , it reduces febrile 
temperature, but has no influence over that of health. This anti- 
pyretic action is very marked, occurs suddenly about fifteen 
minutes after salol has been taken, and is to a certain extent 
independent of the amount administered ; * that is to say, repeated 
doses will not lower a temperature already reduced by a single 
dose, although they will maintain the reduction. Simultaneously 
with the decline of the fever, sweating occurs, as in the case of 
the other agents of this group, but it is not marked, nor do the 
chilly sensations which sometimes precede the rise of tempera- 
ture ever amount to a distinct chillf. The circulation is but 
little influenced, even by large doses of salol (Lombard, loc. cit), 
but the respirations increase rapidly, so much so, that at the 
expiration of ten minutes after taking the medicine they have 
doubled in frequency, at the same time becoming very shallow, 
and although they are soon slowed, yet some time elapses 
before they return to their normal depth. Salol also possesses 
analgesic properties in common with other antipyretics of the 
aromatic series of carbon compounds, but this subject has as yet 
not been sufficiently investigated, to warrant a positive statement 
regarding its cause. 

When salol is taken with food, it is said to pass unchanged 
and undissolved through the stomach into the duodenum, where, 
under the action of the pancreatic juice, it is converted into car- 
bolic and salicylic acids ; hence it will act as an intestinal anti- 
septic without affecting the stomach. It is said, too, to render 
the bile more fluid. 

No toxic symptoms have been observed, and it is believed to 
be innocuous. It is eliminated principally by the kidneys, under 



* Bull. Get^. de Therap., Sept. i^ieme, iSSj, Dr. Lombard, 
f Deutsch. Med. Wochenschr., No. 19, 1887, Dr. Herrlich. 



494 MATERIA MEDICA TOPICAL MEDICINES. 

the form of salicyluric acid and phenol-ether-sulphuric acid, the 
latter imparting the dark color to the urine, although, during a 
course of salol, the urine assumes a dark hue similar to that seen 
when large amounts of carbolic acid are taken. 

Salol has been much used in acute rheumatism to lower the 
temperature and relieve pain, and although it does this most 
promptly, yet its effects are much more evanescent than are those 
of sodium salicylate. It neither prevents relapses nor lessens 
the tendency to cardiac complications. It has also been used in 
small doses to lower the temperature in phthisis (gr. j-iij every 
few hours), and is recommended in typhoid fever and in pneu- 
monia for a similar purpose. 

It has been found very serviceable in intestinal catarrh, 
especially when the upper part of the tube is affected ; thus in 
catarrh of the duodenum it is of special value, as it is there that 
it is re-converted into its constituent parts. As it tends to 
liquefy the bile, it is also recommended in catarrhal jaundice, in 
cases of occlusion of the bile-ducts from inspissated bile, and it 
has been found useful in diabetes. 

Prof, von Nencki and others recommend it in the treatment of 
vesical catarrh, since it has been found to entirely prevent the 
decomposition of urine when mixed with it ; and, since its com- 
ponent parts are eliminated unchanged by the kidneys, a similar 
effect probably follows its internal administration. 

Like many of the antipyretics, it possesses the property, when 
administered internally (gr. iij-x t. d.), of relieving the pains of 
locomotor ataxia, neuritis, nervous headache and neuralgia to a 
remarkable degree, and also exerts a similar, though less marked, 
influence over lumbago, myalgia and other muscular pains. 

Locally it has been used as an antiseptic in dressing wounds, 
ulcers and other surgical affections ; and, as it does not appear 
to be toxic, and is to a great extent free from disagreeable odor, 
it would seem to be an excellent substitute for iodoform. 

Administration. — It may be given in capsules, pills, powder or 
in solution in alcohol or in oil. The dose ranges from gr. v-3j. 
As an antipyretic the average dose is gr. xv-xxx, and as much 
as 5ij-hj have been administered in twenty-four hours without 
deleterious effects. 



ANTISEPTICS AND ANTIPYRETICS NAPHTHALINE. 495 

NAPHTHALINE. 

Naphthaline (not officinal), when pure, occurs as thin, white, 
shining, rhombic crystals, having a strong, pungent odor and a 
burning taste, insoluble in water, diluted acids or alkalies, but 
dissolving in alcohol, ether and oils*. 

It was introduced into medicine as an expectorant internally, 
and locally as a stimulating applicationf, but was first used as 
an antiseptic by Dr. E. Fischer J, in 1881, who recommended it 
as cheap, innocuous, and as efficacious as carbolic acid. 

Effects and Uses. — Naphthaline is a disinfectant, deodorant, anti- 
fermentative and antiseptic agent, whether applied locally or admin- 
istered internally. It has no antipyretic action. It does not 
irritate the stomach — in fact, it is believed to pass unchanged 
through that organ into the intestine, and there to act as an anti- 
septic, rendering the stools inodorous, or imparting to them its 
own odor to a slight degree. Although very insoluble, it is to 
some extent absorbed, and eliminated by the lungs and kidneys, 
imparting a dark color to the urine (Binz), and in large doses 
irritating the kidneys, and even in some cases causing violent 
cystitis, with strangury§. In medicinal doses, it retards or pre- 
vents decomposition of the urine, and hence is of value in cys- 
titis. It is not toxic, probably because of its insolubility. 

It is chiefly used internally || as an antiseptic in the treatment of 
gastro-intestinal and renal and cystic disorders. 

In indigestion due to fermentation of food ; in acute gastro- 
intestinal catarrh (combined with opium) ; in chronic gastro- 
intestinal catarrh, to prevent fermentation and the consequent 
nausea, heartburn and eructations, it is highly recommended. 

In diarrhoea and in dysentery it has also proved of use, but 



* Wienner Med. Blatter, No. 28, 1885, Binz. 

f Journ. de Pkarm. et de Chim., 1842, Dupasquier. 

% Berlin, klin. Wochensch., XIX, 1882, p. 1 1 3-1 1 6. 

\ Ibid., No. 42, 1884, Rossbach. 

|| Cf. Binz, op. cit.; Voenno-Sanilarnoe Delo, No. 46, 1885, p. 514, Novikoff; 
Rossbach, op. cit.- Vratch, No. 26, 1886, p. 482, Koriander; Ibid., No. 36, 1887, 
p. 685, Lunin; El Genio Med.-Quirurg, Oct. 7, 1886, Dr. R. Serret ; Meditz- 
Obozr., Fa.sc. xix, 1885, p. 630, Dr. A. Sn'iatkoff; Jahrbuch f. Kinderheilkunde, 
Vol. xxvi, Nos. 3 and 4, 1887, and Centralbl. f. die gesam. Therap., Oct., 1887, 
Widowitz : el al. 



496 MATERIA MEDICA TOPICAL MEDICINES. 

would appear to act more beneficially when combined with an 
evacuant plan of treatment than when given alone. 

It is also recommended in typhoid fever. 

In pyelo-nephritis, cystitis acute or chronic, chronic prostatitis 
with retention and decomposition of urine, and in cases of old 
strictures with multiple fistulae and ammoniacal urine, in doses of 
gr. xx, it is said rapidly to render the urine sweet, either limpid, 
neutral or acid in reaction, while it causes the pus to diminish or 
disappear altogether from that fluid. 

It has also been successfully used to cause the expulsion of 
parasites from the alimentary canal, and may be administered for 
this purpose to children in cases of lumbrici or ascarides in doses 
of gr. j-iij t. d., or to adults with taenia, in gr. xx-lxxx daily in 
divided doses (Koriander). 

It is also recommended as an expectorant.* 

Locally, \ it has been much lauded as a substitute for iodoform in 
the antiseptic treatment of wounds, abscesses and ulcers, either 
venereal or common ; and has been used as a surgical dressing 
after surgical operations, and even after amputations, but does not 
appear to possess any special advantage over the stronger anti- 
septics (as corrosive sublimate) when carefully used (H. M.). 

Administration. — Dose, gr. ss-viij to an adult. As much as gr. 
Ixxx have been given without unpleasant results in twenty-four 
hours, but as cases of cystitis and strangury are sometimes pro- 
duced, it is best to be cautious in administering naphthaline to a 
person unaccustomed to the drug. 

It is better administered in compressed pills or in capsules. 

Locally, it may be used either in the form of powder, ethereal 
solution (5ss-j in ether f §ss) or ointment with vaseline. 

The peculiar and disagreeable odor of naphthaline may be 



* Dupasquier, op. cit. ; Meditz. Pribav. k'Morsk, Shorn., Mar., l885,p. 218, Dr. S. 
M. Karst. 

f Cf. Dr. E. Fischer, op. cit. ; A monograph, " Ueber die Wundbehandlung mit 
Naphtalin" Strassburg, 1882, by Dr. Carl Bonning ; Vratch, No. 39, 1882, and No. 
2, 1883, Dr. P. T. Diakonoff; Ibid. No. 25, 1885, p. 406, Dovodtchikoff ; Ibid. No. 
28, 1884, p. 464, Dr. Jutzuta; Annals Anat. and Surg., May, 1883, Dr. George R. 
Fowler; Cenlralbl.f. Chir., No. 72, 1882, Dr. Ploftmann; Ibid. No. 50, Dr. Hager, 
Gaz lekarska, Nos. 7 and 8, 1883, Dr. Klink ; Rivista di Chim.-Med. e Farm., 
1883, Dr. C. Raimondi; et al. 



ANTISEPTICS AND ANTIPYRETICS PYRIDINE. 497 

altered and even rendered pleasant by trituration with a small 
quantity of the oil of bergamot *. 

Naphthol (C 10 H 7 OH, — not officinal) is beta- or w<?-naphthol, 
derived from naphthaline. It occurs in the form of white crys- 
tals, almost insoluble in water, but soluble in alcohol, ether, 
chloroform and most of the oils. 

Effects and Uses. — Locally, it is an antiseptic, somewhat resem- 
bling tar in its action. When applied too freely, it may become 
absorbed, causing vomiting, insensibility, convulsions and hema- 
turia (Neisser). It is used in parasitic skin diseases as scabies, 
ring-worm, pityriasis versicolor f, etc. 

Dr. John Wolff recommends a solution in alcohol as a preserv- 
ative for anatomical specimens. It is employed in an alcohol 
solution (y 2 to 5 per cent.), or as an ointment (10 per cent.), and 
should be used with caution. 

Pyridine (not officinal) is a clear, colorless, volatile liquid, with 
a strong, somewhat aromatic odor, and a burning taste ; having 
a sp. gr. 0.98 ; boiling at 240.8 F. and being readily miscible 
with water, alcohol, ether, benzine and the fixed oils, the result- 
ing solutions being clear and, in the case of the watery solution, 
of an exceedingly alkaline reaction. 

Effects and Uses. — When the vapor is inhaled by the lower 
animals the inherent irritability of the respiratory centre is 
greatly diminished, and the breathing becomes less frequent.J 
When inhaled by ma'n, less air is respired in a given period ; indeed 
the feeling of need of air is diminished, while the respiratory 
curve in a healthy individual shows expiratory dyspnoea. The 
respiration becomes less frequent, irregular, somewhat periodic, 
and sometimes long intervals of apncea are observed. After the 
inhalation, the breathing remains for some time less frequent and 
less full, with occasional deep inspirations. There is always 
abundant salivation, coryza, and increase of bronchial mucus, and 
sleep often supervenes. As the same effects (excepting the de- 

* Am. Druggist, Jan., 1885, p. 17. 

f Pamietnik Towarz. Lek. Warz, Vol. lxxviii, E. Klink. 

\Bull. Gin. de Therap., Juin 30^™^ 1885. Drs. Germain See, et Bochefantaine. 
32 



49^ MATERIA MEDICA TOPICAL MEDICINES. 

creased need of air, sleep and increase of bronchial secretion) 
are observed when the nostrils are irritated by a faradaic current, 
Dr. Silva* believes that pyridine acts on the respiratory centre 
chiefly through the trigemini, but to some extent also by the 
vagi. According to De Renzi f it is well borne by the stomach in 
doses of gtt. vj-xxv in water, and notably increases the force, while 
diminishing the frequency of the cardiac systole. The arterial 
pressure is raised. It has very slight antipyretic properties. J 

It was first recommended as an inhalation, by Prof. See, in 
asthma. For this purpose f5j may be poured on a plate placed 
in a small room or closet, in which the patient remains for twenty 
or thirty minutes at a time, thrice daily. This treatment lessens 
the dyspncea rapidly in all forms of asthma, and is free from 
dangerous consequences, § as pyridine is rapidly absorbed and as 
rapidly eliminated by the urine. 

In angina pectoris it is said to act very favorably and rapidly. || 
According to De Renzi its action much resembles that of digi- 
talis, for which it may often be substituted with advantage, as its 
effects are more rapidly produced, and, being quickly eliminated, 
its action is not cumulative. 

Chinoline (not officinal) is now manufactured synthetically in 
a pure state from aniline or nitro-benzol by the action of gly- 
cerin in the presence of a dehydrating agent by the process of 
Skraup, but was first obtained from coal tar by Runge and after- 
wards by Gerhardt and by Vyshnegradski from the cinchona 
alkaloids by decomposition. When pure it is an oily, colorless 
liquid with an aromatic odor, which combines readily with acids 
forming salts of which the tartrate only is not deliquescent. 

Effects and Uses. — Chinoline'^ is antiseptic and a?itipyretic, dif- 
fering but little in its effects from other agents of this group. 
Simultaneously with the lowering of the temperature diaphoresis 
occurs which is sometimes profuse. This is preceded by a perrod 

* Gazz. delle Cliniche, June, 1886. f Riv. Clin, e Terap., No. 3, 1887. 

% Vratch, No. 21, 1882. Dr. K. K. Sakovski. 

§ N. Y. Med. /., Mar. 13, 1886. Dr. Jos. Neff. Der Fortschritt, No. 1, Jan. 5, 
1887. Dr. Wyss. 

|| A monograph, " De la Pyridine et de la Collidine comme medicaments respira- 
toires." Par le Docteur Dandien, Paris, 1886; Dr. Wyss, op. cit. ; De Renzi, op. cit. 



ANTISEPTICS AND ANTIPYRETICS KAIRINE. 499 

of excitement, flushing of the face, accelerated cardiac action 
and elevated arterial tension, and is followed by a diminution in 
the frequency of the heart beat and respiration. According to 
Dr. N. Sudeikin* besides lowering the temperature, it acts chiefly 
on the nerve-centres, especially those of the spinal cord and 
medulla oblongata, paralyzing their reflex activity. It depresses 
and in large doses paralyzes the respiratory centres and the excito- 
motor cardiac nerves. The hope at one time entertained, that in 
this remedy the long-sought-for substitute for quinine had at 
length been found, has been doomed to disappointment, but it 
is undoubtedly a powerful antipyretic and to some extent an 
antiseptic. 

It has been used to lower the temperature in typhoid fever, 
acute rheumatism and erysipelas. In pneumonia and malarial 
fevers it is decidedly inferior to other agents, and in phthisis it is 
not to be recommended. 

The more recent antipyretics are probably preferable, as from 
the comparative smallness of dose they can be more readily 
handled and are not so apt to cause profound depression. 

The pure drug may be administered hypodermically in solution 
in olive oil (i to 2) which is said not to cause irritation or inflam- 
mation^ or the tartrate may be given internally in solution — 
dose gr. vij-xv. 

Kairine (not officinal) is a pale buff-colored powder, slightly 
soluble in water, having a bitter, disagreeable taste. 

Effects and Uses. — It was first investigated physiologically, by 
Prof. Filehne of Erlangen,J who recommended it highly as an 
antipyretic, for which purpose it was largely used for several 
years in the treatment of numerous diseases accompanied by 
high febrile temperature. Of late, however, it has been super- 
seded as an antipyretic by antipyrine, acetanilide and other more 
recent and, probably, less dangerous members of this group of 
medicines. In brief, its action is as follows : § 

It is a blood-poison acting on the red-corpuscles, destroying 

* Vratch, Nos. 29 and 30, 1882. f Vratch, No. 21, 1882. Sakovski. 

% Berlin. Klin. Wochensch., No. 45, 1882, und No. 6, 1883. 
I Si. Petersburg Inaug. Dissert., 1885. Dr. M. K. Popoff. 
Meditz. Oberz., Fasc. 4, 1884 p. 406. Dr. L. M. Popoff. 



500 MATERIA MEDICA TOPICAL MEDICINES. 

the hemoglobin with the formation of methemoglobin,* and 
partly destroying the plasma. Febrile temperature is rapidly 
reduced to the normal, the fall being accompanied by profuse 
sweating ; but after a short time the temperature again rises, 
preceding which rigors sometimes occur. The reflex centres of 
the cord are depressed and finally paralyzed if a large amount has 
been taken. The cardiac action is at first slowed (from depression 
of the excito-motor cardiac ganglia, and probably also from irrita- 
tion of the inhibitory cardiac ganglia), but is afterwards accele- 
rated (from excitation of the central ends of the accelerator 
fibres of the vagi), and finally in fatal cases, paralysis of the 
motor cardiac ganglia, and arrest of cardiac contractions ensues, 
the cavities of the heart being greatly distended. Respiration 
is slowed, and, when lethal amounts are taken, ceases from 
paralysis of that centre before the heart stops beating. Paresis, 
and finally complete paralysis of central origin results. The 
peripheral endings of the sensory nerves are at first excited, 
then paralyzed. When Kairine is administered hypodermically 
local anaesthesia is always produced around the seat of injection. 

Kairine is rapidly excreted and the lesions of the tissues and 
of the blood are not lasting, the animal recovering, even if 
symptoms of dangerous collapse are present, when the medicine 
is removed from the system either by the urine or by venesec- 
tion. It is eliminated chiefly by the urine, which is of a dark 
green color during its passage from the system. Cyanosis is 
often observed. 

The conclusion arrived at by Beyer,f which we cordially en- 
dorse, is that " the distinctive influence it exerts on the red blood- 
corpuscles " " and the weakening effect upon the heart, render 
its employment objectionable and dangerous." 

Dose, gr. iij-xxx. The average dose in fevers is gr. viij-xv, 
repeated hourly until the temperature falls, when the dose is 
decreased. It may be given in capsules or wafers. 

Thalline (not officinal) is a synthetically prepared alkaloid 
belonging to this series, being chemically tetrahydroparamethyl- 



*Meditz. Oberz., Fasc. 9, 1884, p. 928. L. Morokhovez. 

f Am. J. Med. Sc, Apr., 1886, p. 382. H. G. Beyer, m. D., U. S. Navy, M.R.C.S. 



ANTISEPTICS AND ANTIPYRETICS THALLINE. 501 

oxychinoline. The sulphate is the salt most generally in use, 
although the tartrate and hydrochlorate have also been em- 
ployed. Thalline sulphate is a light buff-colored powder, with a 
sharp, strongly bitter taste, and a slight phenol-like odor. The 
salts are all readily soluble in water. 

Effects and Uses. — Locally, thalline is an antiseptic and antifer- 
mentative agent. Internally, it lowers the temperature of fever, 
having little or no effect. on that of health. The cutaneous ves- 
sels dilate, and while the internal temperature is lowered, that of 
the surface is elevated until they nearly correspond, while at the 
same time there is an increased radiation of heat from the sur- 
face,* and diaphoresis occurs, which, however, is not as great as 
that produced by kairine. As an antipyretic it acts rapidly, but 
the effect passes away in 4 or 5 hours, a more or less distinct 
rigor occurring, usually not severe, followed by return of. the 
fever. The pulse and respiration are both diminished in fre- 
quency, and the arterial tension is at first elevated, afterward 
depressed. f According to Beyer (pp. cit.) when injected into the 
blood of frogs and turtles, small doses temporarily increase the 
heart-rate, but slightly diminish the work done by it; in larger 
doses there is a decrease both of the cardiac rate and work, espe- 
cially the latter; very large doses cause diastolic arrest, five 
times as much being required as when kairine is used. The 
respiratory capacity of the blood after the administration of 
thalline, was measured by Maragliano and found to be reduced. 

Thalline is eliminated chiefly by the urine, to which it imparts 
a dark green color, and in which it can be detected from ^ to 1 
hour after being taken. J According to some observers! it de- 
creases the quantity of urine passed, while increasing its spe- 
cific gravity. The elimination of carbonic acid is reduced one- 
half, and the amount of urea excreted one-third (Maragliano). 
Ehrlich|| found that when given in excessive doses (to animals) 
for some time it collects in large quantities in the adipose tissues, 
being absorbed with great avidity by the oil- drops, and given up 

* Vratch, No. 2; 4; 1887. Pasternatzky. 

-j- Gazz. degli ospitali, July 5, 1 885. Maragliano. 

% Wien. Meditz. Wochensch., No. 48, 1884. Von Jaksch ; Maragliano. op. cit. 

I Fuss. Medilz., No. I, 1886., p. 6. Britneff. 

|| Deutsche Med. Wochensch., No. 48, 1886. 



502 MATERIA MEDICA TOPICAL MEDICINES. 

slowly, unchanged, to the blood. Given in this way, he finds 
that thalline causes, ist. Adipose degenerations, particularly 
affecting the heart and the renal tubules, probably due to the 
deoxydizing influence of the drug. 2d. " Vascular necrosis," 
affecting especially the region of the salivary glands and slight 
similar changes in the pancreas ; and 3d. Papillary infarction of 
the kidney, hemorrhagic in character. He found death was pre- 
ceded by muscular tremors, tetanus, and ptyalism, but was always 
able to arrest a fatal termination by administering oxygenated 
oil of turpentine as an antidote to the poison. He has never 
found large doses, in practice, to have any bad effect, although 
he has given as much as 10 to 15 grammes a day. A number 
of cases of severe rigors have, however, been observed by 
others, and symptoms of collapse have followed its use. 

Thalline, although probably not preferable to either acetani- 
lide or antipyrine, is an antipyretic which promises more than 
either hydroquinone or kairine, and is certainly much safer than 
the latter. It has been used in typhoid fever, pneumonia, pleu- 
risy, diphtheria, measles, erysipelas, and other affections charac- 
terized by high fever; but, like other antipyretics, while lower- 
ing the temperature, it exerts little if any influence on the course 
of the disease. It would seem to have but slight effect in rheu- 
matism or in malarial fevers. In phthisis it should be given 
with caution, as it is apt to weaken the patient by tending to in- 
crease the colliquative sweats (Landenberger), while in debili- 
tated subjects, no matter what the disease, care should also be 
taken for fear of collapse, which is particularly apt to occur when 
the drug is administered to such patients.* It is usually well 
borne by the stomach. 

Administration. — Dose, gr. iv-xvj in pills or capsules, repeated 
whenever the temperature tends to rise. 

BritnefT and others recommend a single daily dose of gr xij- 
xvj, thus obtaining a more intense and prolonged antipyretic 
effect, and only producing one sweat and rigor per day. On the 
other hand, Ehrlich recommends in typhoid fever, small doses 
(gr. j-iij) repeated hourly and rapidly increased until a com- 
plete condition of apyrexia is produced, which is then to be 

* Russ. Meditz., No. 14, 1886, p. 240. Britneff. 



ANTISEPTICS AND ANTIPYRETICS ANTIPYRINE. 503 

maintained by the repetition of the maximum dose, either until 
from the symptoms it is probable that the disease has run its 
course, or until the height of the fever is past, when he substi- 
tutes the hydropathic treatment for thalline. 

ANTIPYRINE. 

Antipyrine (not officinal), a synthetically prepared alkaloid 
which combines readily with acids, forming salts, is a whitish 
crystalline powder, very soluble in water, with a sweetish bitter 
taste. 

Effects and Uses. — The action of antipyrine is very similar to 
that of other antipyretic remedies. According to Pasternatzki,* 
it rapidly reduces the temperature in the febrile state, acting as 
do acetanilide and thallin (q. v.) by diminishing nitrogenous 
metamorphosis (thus decreasing heat-production), and by regu- 
lating heat-distribution (thus increasing heat-radiation), but 
Beyer f found as the result of his carefully conducted experi- 
ments that this antipyretic action was due entirely to increased 
heat-radiation caused by the extensive dilatation of the veins and 
capillaries which this remedy induces. The perspiration which 
accompanies the decline of temperature may be very profuse, 
but after the period of apyrexia, which lasts from four to twelve 
hours or even longer, the return of fever, although sometimes 
ushered in by a chill, is much less apt to be characterized by a 
severe rigor and even collapse than is the case with kairin or 
thalline. Antipyrine increases to some extent "the power of 
contraction of both auricles and ventricles " (Beyer), and hence 
is a cardiac tonic. It elevates the arterial pressure to a slight 
degree. 

In medicinal doses it does not affect the constitution of the 
blood. Like many other antipyretics it depresses the reflexes 
and is analgesic. It is excreted chiefly by the kidneys and may 
be detected in the urine for two or three days after its adminis- 
tration has been suspended.J Occasionally antipyrine causes a 
cutaneous eruption, usually erythematous but sometimes papular 
or vesicular. Locally it is antiseptic and antifermentative. 



* Op. cit. f Am. J. M. Sc, Apr., 1886, p. 402. 

%Rev. de Therap., Mai 15, 1887. Prof. Germain See. 



504 MATERIA MEDICA TOPICAL MEDICINES. 

Antipyrine is used, as its name implies, as an antipyretic, and 
analgesic. For the former purpose it is probably more generally 
employed at present than any other agent except acetanilide. In 
typhoid fever, when the temperature is high, antipyrine is of the 
greatest value, but it possesses no more power over the disease 
process than do the other remedies already discussed. In tuber- 
culosis also, gr. xv at the onset of the fever, repeated if neces- 
sary, will be found efficacious, and in acute rheumatism numerous 
observers attest to its good effects, not only in lowering the tem- 
perature but also in relieving the pain. It does not, however, 
lessen the danger of cardiac complications, nor the liability to 
relapse. In sunstroke with high temperature it acts most bene- 
ficently. It has also been advantageously administered in ery- 
sipelas, pneumonia, the various exanthemata, and surgical fever. 
It is not an antiperiodic, although it may be used to moderate the 
fever of malarial affections, yet it will not prevent the return 
of the paroxysm. 

As an analgesic it is a valuable addition to our armamenta- 
rium. For the purpose of palliating the pain of muscular 
rheumatism, in neuralgia of the superficies, of preventing an 
attack of asthma, in fact as a succedaneum of morphine, Dr. A. 
Wolff* finds, as the result of numerous experiments, in the sub- 
cutaneous injection of antipyrine, an efficient and quickly-acting 
remedy, and one which is not succeeded by inflammation at the 
seat of introduction. The " lightning pains" of locomotor ataxia 
are often promptly relieved by doses of gr. x-xv repeated as neces- 
sary, and various neuralgic affections, as sciatica, tic-douloureux, 
hemicrania and other nervous conditions characterized by pain 
(Germain See) are often cured by its timely administration. In 
muscular rheumatism and myalgia it has, too, been used with 
good results. 

Antipyrine in doses of gr. x-xv will often allay the pain in the 
first stages of labor without apparently interfering with the pro- 
cess of dilatation of the os uteri. 

Administration. — Dose, gr. v— 5j. The average dose as an anti- 
pyretic is gr. xv— xxx repeated ; as an analgesic gr. x— xv repeated 
in from one to four hours if necessary. It may be administered 

* Therapeutische Monats., No. 6, 1888; quoted. 



ANTISEPTICS AND ANTIPYRETICS THYMOL. 505 

either in solution or in capsules, or as it is readily soluble, by 
hypodermic injection. 

Many of the essential oils as well as the camphors obtained from 
them have proved to be antiseptic. Among these may be men- 
tioned the oils of cloves, gaultheria, peppermint (q. v.), and thyme. 
Menthol, too (v. p. 224), derived from the oil of peppermint is a 
local anaesthetic as well as antiseptic, and has been considered 
under the head of aromatics, but thymol deserves a more extended 
notice as an antiseptic. 

THYMOL. 

Thymol (C 10 H 13 HO), called also cymylic phenol, is a solid crys- 
talline substance found in the volatile oil {oleum thymi) distilled 
from thymus vulgaris (vide p. 225.) It is separated by fractional 
distillation; that portion of the oil which distils above 392 F. 
is agitated with a concentrated solution of caustic soda, and the 
thymol liberated from the resulting solution by hydrochloric 
acid. It is purified by rectification, and occurs as large, color- 
less, rhombohedral crystals, having an aromatic odor and a hot, 
aromatic taste ; slightly soluble in water, but very soluble in 
ether and alcohol. 

Effects and Uses. — Thymol is a powerful antiseptic. Its effects 
are analogous to carbolic acid, and like that agent, when locally 
applied it produces paralysis of the cutaneous end-organs of the 
sensory nerves (Lewin). When given internally it produced 
tinnitus aurium, deafness, reduction of temperature, and often 
diarrhoea, sometimes nausea and vomiting. In several cases its 
ingestion caused violent delirium and collapse; profuse diapho- 
resis took place, and the urine was of a dark green color, but 
free from albumen; the sweating was not as marked as that pro- 
duced by salicylic acid, nor was the antipyretic effect as great. 
As an antiseptic in inflammations and ulcerations of the mouth 
it is very useful, and has been used as an inhalation to diminish 
the expectoration of phthisis, etc. It is one of the best intestinal 
antiseptics and may be used in amounts varying from 5ss-j inter- 
nally in abnormal conditions of the intestine attended with 
putrefactive changes in the chyme. It is recommended by 
Bufalini in conjunction with the exclusive proteid diet of 
diabetic patients to prevent the gastro-intestinal disturbance 



506 MATERIA MEDICA TOPICAL MEDICINES. 

which commonly ensues sooner or later upon the withdrawal 
of the carbohydrates, as well as to prevent or remove when 
present, the symptoms due to acetonemia. Locally it is used 
to fulfil the same indications as carbolic acid. Da Costa recom- 
mends crystallized thymol as a gargle in diphtheria. 



ORDER II. IRRITANTS. 

Irritants are medicines which are employed to produce irrita- 
tion or inflammation of the parts to which they are applied. 
They may be subdivided into Rubefacients, Epispastics, Sup- 
purants, and Escharotics. Rubefacients are used merely to 
produce redness of the skin. Epispastics, or Vesicants, cause the 
exhalation of a serous fluid under the cuticle. Suppurants pro- 
duce a crop of pustules. Escharotics exert a chemical action on 
the tissues with which they are placed in contact, and decom- 
pose or destroy them. 

rubefacients. 

Rubefacients are employed to remove congestion and inflam- 
mation, to rouse the capillary system in cases of local torpor, to 
relieve pain and spasm, and as stimulants to the general system 
in coma, syncope, asphyxia, etc. They are adapted to cases in 
which a sudden and powerful, but transient action is called for; 
but they may be also employed where a slight and long-continued 
action is desired. In removing congestion and inflammation, 
rubefacients act by stimulating the capillary vessels of inflamed 
parts, and thereby restoring their tone and elasticity. They are use- 
ful chiefly in the forming stages or in light grades of inflammation. 
They are very serviceable local anodynes when applied to 
painful parts — acting by a substitutive influence. As general 
stimulants, their efficacy in rousing the system depends partly 
on their action on the capillary circulation, and partly on the 
pain which they produce. They are most valuable in the coma 
or asphyxia resulting from poisons, drowning, etc., and are 
inferior to blisters in the cerebral oppression which occurs 
in fevers, inflammations of the brain, etc. 

Rubefacients are usually applied till pain and redness super- 
vene. If kept too long on the skin, many of them will produce 
vesication and even gangrene ; and in cases of coma particularly, 



IRRITANTS BLACK MUSTARD. 



507 



caution is required, as the patient may not feel them till dan- 
gerous inflammation has occurred. 

SINAPIS ALBA WHITE MUSTARD. 

SINAPIS NIGRA BLACK MUSTARD. 

Mustard seed are obtained from two varieties of Sinapis 
— S. nigra, or Black Mustard, and S. alba, or White Mustard 
(Nat. Ord. Cruciferae), small annual European plants, cultivated 
in our gardens. S. nigra has become naturalized in some parts 
of the United States. Black mustard seed are small, globular, of 
a deep brown color externally, and internally yellow. They are 



Fig. 40. 




SINAPIS ALBA ; A. SEED ; B. SEED-POD. 



inodorous, except in powder; and when rubbed with water 
exhale a very strong, pungent smell. Their taste is bitterish, 
hot, and pungent. White mustard seed are larger, yellowish 
externally, and of a less pungent taste, owing to the presence 
of a mucilaginous substance in their skin. The powder of both 
varieties (commonly called flour of mustard) is yellow, and 
is often adulterated with colored wheaten flour. Both varie- 
ties yield their virtues wholly to water, and very slightly 
to alcohol. 



508 MATERIA MEDICA TOPICAL MEDICINES. 

Chemical Constituents. — Mustard seeds yield, upon pressure, 
a fixed saponifiable oil, which contains oleic acid and a peculiar 
acid termed eruic (HC £2 H 41 2 ). From the black seed a very pun- 
gent volatile oil, containing sulphur, is afterwards obtained by 
distillation ; it does not pre-exist in the seeds, but is the result of the 
action of zvater upon a peculiar principle called sinigrin potassium 
myronaie (C 10 H 18 NS 2 KO 10 ), which is split into allyl sulphocyanide 
C 3 H 5 CyS), acid potassium sulphate (KHS0 4 ), and sugar (C 6 H 12 - 
6 ). This oil is colorless or pale yellow, rather heavier than 
water, of a very pungent odor and of an acrid, burning taste. 
Allyl sulphocyanide is the principle to which the black seeds 
owe their activity. From the white seeds no volatile oil is obtained ; 
but when treated with water they yield an acrid fixed principle, 
which is analogous in properties to the volatile oil of the black 
seeds. It is the result of the reaction of water upon sinalbin (C^H^- 
N 2 S 2 1Q ), a peculiar ingredient of the white seeds, which is 
decomposed into acrinyl sulphocyanide (C 8 H 7 NSO), sinapine 
sulphate (C ]6 H 2 5NS0 9 ), and sugar (C 6 H 12 6 ). The development 
of the volatile oil in the black seeds, and of the acrid fixed prin- 
ciple in the white seeds, is supposed to depend upon the presence 
of an albuminous constituent called myrosin, which acts the part 
of a ferment in determining a reaction between water and the 
peculiar principles of the seeds. Myrosin is rendered inert by 
heat, alcohol, and the acids ; and water, of the ordinary tempera- 
ture, is therefore the proper menstruum of mustard. 

Effects and Uses. — -Mustard is an acrid stimulant. In small 
quantities it is stomachic ; in larger doses it proves emetic ; and 
in excessive doses it will produce gastro-enteric inflammation. 
When applied to the skin it is a rapid and powerful local exci- 
tant, speedily producing redness and pain, and if long continued, 
vesication, ulceration, and even sphacelus. Mustard seeds, swal- 
lowed whole, have been used as a laxative in dyspepsia, in the 
dose of a tablespoonful once or twice a day, mixed with molas- 
ses ; the white seeds are preferred ; the practice is, however, of 
doubtful value, as they may become entangled in the appendicula 
vermiformis. When mustard is employed internally, however, 
it is chiefly as an emetic, in cases of torpor of the stomach, par- 
ticularly after narcotic poisoning ; and by its stimulant action, 
mustard often arouses the gastric susceptibility when other 



IRRITANTS BLACK MUSTARD. 509 

emetics fail. Dose, as an emetic, from a large teaspoonful to a 
tablespoonful of the bruised seeds or powder. Its use in smaller 
quantity, as a condiment and stimulant of the digestive organs, 
is well known. In the form of whey (Sss boiled in milk Oj) it 
has been given as a diuretic in dropsy. 

The most general use of mustard is, however, as a cutaneous 
stimulant, in the form of cataplasm (termed a sinapism). This is 
made by mixing flour of mustard with a sufficient quantity of 
tepid water to give it proper consistence, and it may be diluted 
with wheat or rye flour if a weaker effect is desired. Sinapisms 
are used when a speedy and powerful rubefacient effect is 
required ; they should be kept on till pain and redness are pro- 
duced, usually from a quarter of an hour to an hour, and in cases 
of insensibility their effects should be carefully watched. They 
are applied spread on linen, and covered with gauze to prevent 
adhesion to the skin. Mustard is the most active and at 
the same time the most easily controlled of the rubefacients; 
a mild but permanent effect may be kept up by the addi- 
tion of a teaspoonful to a tablespoonful of mustard to a 
poultice of Indian meal or flaxseed, with a tablespoonful or two 
of capsicum. 

For ready use there is now kept in the shops charta sinapis 
(mustard paper), which is prepared by mixing black mustard (in 
powder) with enough solution of gutta-percha to give it a semi- 
liquid consistence, and then applying the mixture by a brush to 
a piece of stiff paper; each square inch contains about gr. vj of 
mustard. Before being applied to the skin it should be dipped 
for about fifteen seconds in warm water. 

Oleum sinapis volatile (volatile oil of mustard), the volatile oil 
obtained from black mustard by maceration with water and sub- 
sequent distillation, possesses the properties of mustard. It is 
very irritant. It is used in making — 

Linimentum sinapis compositum {compound liniment of mustard), 
which is composed of volatile oil of mustard 1(3 parts), extract of 
mezereum (2 parts), camphor (6 parts), castor oil (15 parts), and 
alcohol (enough to make 100 parts by weight). 



5 TO MATERIA MEDICA — TOPICAL MEDICINES. 

CAPSICUM. I 

Capsicum has been previously noticed as an aromatic stimulant 
(p. 215). It is an efficient rubefacient, useful in rheumatism, low 
fevers, etc. ; the plaster, tincture, or oleo-resin may be used. 

OLEUM TEREBINTHIN.E OIL OF TURPENTINE. 

The Oil of Turpentine (p. 384) is a speedy and efficacious rubefa- 
cient, and sometimes produces a vesicular eruption. It is employed 
in low forms of disease attended with coldness of the surface ; as 
a counter-irritant in inflammation ; and as a stimulating liniment in 
rheumatic and paralytic cases. It is often diluted with olive oil. 

LINIMENTUM AMMONLE LINIMENT OF AMMONIA. 

This preparation, called also Volatile Liniment, consists of 30 
parts of water of ammonia (seep. 212, et sea.) and 70 parts cotton- 
seed oil. It is an excellent application, as a counter-irritant, in 
affections of the throat and chest, etc. 

PIX BURGUNDICA BURGUNDY PITCH. 

This is the prepared resinous exudation from Abies excelsa, 
or Norway Spruce (Nat. Ord. Coniferae), a lofty evergreen tree 
of Europe and northern Asia. Abies picea, or the European 
Silver Fir, is said to be also a source of the drug. It is obtained 
by stripping off the bark and detaching the flakes of resinous 
matter which form upon the surface of the wound ; they are 
afterwards melted in boiling water and strained. Burgundy 
pitch is collected principally in Germany and France, and derives 
its name from Burgundy, in the latter country. After it is 
imported into the United States it is generally re-melted and 
strained to free it from impurities ; and as found in the shops it 
is a hard, brittle, opaque substance, of a yellowish or brownish- 
yellow color and a weak terebinthinate taste and smell ; when 
applied to the body it softens and becomes adhesive. It contains 
resin and a much smaller proportion of volatile oil (C 10 H 16 ) than 
turpentine. 

A spurious Burgundy pitch is made by melting together pitch, 
resin and turpentine, and agitating the mixture with water. 

Effects and Uses. — This is a gentle rubefacient, producing a slight 
degree of inflammation and serous effusion, without separating 



IRRITANTS — CANADA PITCH. 5 1 1 

the cuticle. It occasionally produces a papillary or vesicular 
eruption ; and sometimes, though rarely, occasions painful vesi- 
cation and even ulceration. It is applied in the form of plaster 
to the chest in chronic and subacute pulmonary disorders, to 
the loins in lumbago, to the joints in chronic articular affections, 
and for the relief of local rheumatic pains in other parts. 

Emplastrum picis Burgnndicce (Burgundy pitch-plaster) consists 
of 80 parts of Burgundy pitch melted with 10 parts of yellow 
wax, which is used to give consistence to the pitch. Emplastrum 
picis cum cantharide (pitch-plaster with cantharides) consists of 92 
parts of Burgundy pitch melted with 8 parts of cerate of canthari- 
des : this is commonly called the warming plaster, and is a more 
active rubefacient than Burgundy pitch, though it does not 
usually blister. The iron-plaster, galbanum-plaster and opium- 
plaster all contain Burgundy pitch. 

PIX CANADENSIS CANADA PITCH. 

This is the prepared resinous exduation from Abies cana- 
densis, or Hemlock Spruce (Nat. Ord. Coniferse), a very lofty 
evergreen tree of Canada and the northern part of the United 
States. The pitch (sometimes called hemlock-gum) is a sponta- 
neous exudation on the old trees. The portions of bark upon 
which it hardens are stripped from the tree and boiled, and the 
melted pitch is skimmed from the surface of the water. It under- 
goes a further purification in the shops by melting and straining, 
and is found in hard, brittle, opaque masses, of a dark yellowish- 
brown color, a weak, peculiar odor and scarcely any taste. It is 
more readily softened by heat than Burgundy pitch, and is, 
therefore, sometimes a less convenient application. Its constitu- 
ents are resins and a minute portion of volatile oil. Its effects and 
uses are the same as those of Burgundy pitch. 

Emplastrum Picis Canadensis (Canada pitch-plaster), sometimes 
called hemlock pitch-plaster, consists of 90 parts of Canada pitch 
melted with 10 parts of yellow wax. 

Many other acrid substances are occasionally employed as 
rubefacients. Ginger (vide p. 219), Black Pepper (vide p. 216) 
and Garlic (vide p. 381) are particularly deserving of mention. 
A gentle counter-irritant, often used to the epigastric region to 



512 MATERIA MEDICA TOPICAL MEDICINES. 

relieve vomiting, is the spice-plaster, which is made by mixing 
Sij of powdered ginger with Sj of powdered cloves and cinnamon, 
each, and 5ij of capsicum, adding fSss of tincture of ginger and 
honey enough for proper consistence. 

EPISPASTICS. 

Epispastics, called also Vesicants and Blisters, are medicines 
which, when applied to the skin, produce inflammation, accom- 
panied by effusion of serum beneath the cuticle. Many of the 
rubefacients will blister if kept on the skin a sufficient length of 
time ; and, on the other hand, the action of vesicants may be 
made not to extend beyond rubefaction. The inflammation of 
the skin caused by vesicants is erysipelatous in its character, and 
may result in suppuration, and even sloughing or gangrene. In 
inflammation of the dermoid tissues, as rubeola and scarlatina, 
in typhus under certain circumstances, and in extreme infancy, 
vesicants may produce serious consequences. 

This class of agents is employed — I. As local stimulants, in 
the cure of internal inflammations. Different explanations have 
been offered of the antiphlogistic influence of blisters, some 
therapeutists ascribing it to a derivative or revellent action, by 
determining vascular and nervous energy to the seat of their 
operation, but it is more probably due to a stimulant effect 
extended to the capillary vessels of the inflamed organ, and 
experience has shown that, for the relief of internal inflamma- 
tion, they cannot be applied too near the affected organ. In 
affections of the head, blisters are pre-eminently useful. 2. To 
substitute a healthy therapeutic inflammatory action, which sub- 
sides spontaneously, for a morbid action existing in the part to 
which they are applied. In this way vesicants are used for the 
cure of various cutaneous eruptions. 3. To relieve pain, which 
they do partly by a stimulant and partly by a substitutive influ- 
ence. 4. To break up a train of morbid associations by the 
powerful impression which they make on the nervous system, 
as in the cure of intermittent fever, spasmodic diseases, etc. 
5. To stimulate the absorbing or secreting vessels of parts con- 
tiguous to the seat of their application ; in this way they are 
useful in promoting the absorption of dropsical effusions, in the 
treatment of ununited fracture, etc. 6. As general stimulants, 



IRRITANTS CANTHARIDES. 5 I 3 

in typhoid conditions of the system, coma, syncope, etc. 7. As 
local stimulants, in threatened gangrene, paralysis, etc. 8. As 
evacuants, chiefly for the purpose of local depletion. 9. In 
retrocedent gout, and in retrocession of the exanthematous 
eruptions. 10. To prepare a surface for the endermic applica- 
tion of medicines. 

CANTHARIS CANTHAR IDES. 

Cantharis vesicatoria, termed also Lytta vesicatoria, the Span- 
ish Fly (Class, Insecta; Order, Coleoptera), is a cylindrical 
insect, from six to ten lines in length by two or three in breadth, 
with a large cordate head, an oblong body, and elytra, or wing- 
cases, of a beautiful, shining, golden-green color. 



Fig. 41. 




CANTHARIS VESICATORIA. 



It is found most abundantly in Spain, Italy and the south of 
France, but occurs in all the temperate parts of Europe, and in 
western Asia. The Spanish flies swarm on certain trees and 
shrubs, and may be detected at a considerable distance by their 
strong fetid odor, which resembles that of mice. They make 
their appearance in May and June, and are collected in these 
months by persons protected by masks and gauntlets, who beat 
or shake them from the trees on which they lodge, and receive 
them, as they fall, upon linen cloths spread underneath. They 
are plunged into hot vinegar and water, or exposed to the vapor 
of boiling vinegar, and are afterwards dried in the sun or by 
drying-stoves. When perfectly dry they are packed in canisters, 
which are carefully closed so as to exclude atmospheric moisture. 
They are usually imported into this country from some Medi- 
terranean port. A highly-esteemed variety comes from south 
33 



514 MATERIA MEDICA TOPICAL MEDICINES. 

Russia, through St. Petersburg, which is distinguished by the 
large size and copper color of the flies. 

In the dried state, cantharides retain their form, color, odor, 
etc. ; their taste is acrid, burning and urinous ; their powder is 
of a grayish-brown color, interspersed with shining green par- 
ticles. If exposed to moisture .they are soon decomposed, most 
speedily when powdered. As, moreover, the powder is liable to 
adulterations, they should be always purchased whole, and should 
be powdered as they are wanted for use. They are liable to be 
attacked by mites, which destroy the interior soft parts : the best 
mode of preserving them is to expose them, in bottles, to the 
heat of boiling water, which destroys the eggs of the insect. A 
little camphor or ammonium carbonate, or a few drops of acetic 
acid or of chloroform, added to the flies, are also recommended 
as preservatives. 

The most important constituents of cantharides are a volatile 
oil, upon which the odor depends, and a neutral crystalline sub- 
stance, termed cantharidin (C 10 H 12 O 4 ), which is the vesicating 
principle. Cantharidin is inodorous, tasteless, soluble in ether, 
chloroform, the oils, acetic acid, and boiling alcohol, and nearly 
insoluble in water and cold alcohol ; but notwithstanding the 
insolubility of cantharidin, watery and alcoholic solutions of can- 
tharides possess the medicinal properties of the insect, — the can- 
tharidin being rendered soluble by combination with a yellow 
coloring matter in the insect. By the aid of heat, in the pres- 
ence of water, cantharidin may be made to combine with the 
alkalies, being converted into cantharidic acid (C H 14 O 5 ). 

Physiological Effects. — Cantharides are an acrid stimulant. Taken 
internally, in small doses, they excite the secretion of the kidneys, 
and sometimes produce more or less irritation of the genito- 
urinary passages, evinced by strangury, priapism, pain and occa- 
sionally the discharge of bloody urine. Erotic excitement does 
not, however, always follow the ingestion of cantharides. Palle * 
has recorded his observations on this point, obtained by ques- 
tioning a number of men who had taken it, and in none was am- 
atory desire present. Christison affirms the same thing, while 
Pereira f holds to the contrary. It would seem most probable 

* Journ. de Pharm. et de Chimie, 13, 1871, p. 431. f " Mat. Medica," Vol. 11. 



IRRITANTS CANTHARIDES. 5 I 5 

that only small doses are likely to prove aphrodisiac, large ones 
being too violent in action to admit such an event. Galippe * 
found that when injected into animals the chief symptoms were 
dysuria, hematuria, vomiting, dilatation of the pupil, enfeebling of 
the general sensibility, collapse and death. The main post-mortem 
lesions were inflammation of the digestive tube, kidneys and 
bladder. In large doses they produce violent gastro-enteric and 
genito-urinary inflammation ; and in excessive doses prove fatal, 
with convulsions, tetanus,delirium, and other cerebro-spinal symp- 
toms. Twenty-four grains f have occasioned death, while re- 
covery has followed J the swallowing of f5yj of the tincture. In 
cases of poisoning, after the stomach has been emptied, opiates, 
demulcents and stimulants are to be resorted to ; but oils are to 
be avoided. Applied to the skin, cantharides produce inflamma- 
tion which terminates in the secretion of serum under the cuticle. 
Even when they are externally applied their constitutional effects, 
as strangury, tenesmus, etc., are frequently manifested. 

Medicinal Uses. — The indications which cantharides are capa- 
ble of fulfilling, when administered internally as a diuretic, em- 
menagogue, etc., have been already noticed (see p. 377). Their 
chief use is as an external application, to produce blisters ; but 
they are sometimes employed also externally as rubefacients, for 
the purpose of local or general stimulation in low forms of dis- 
ease. Cantharides are preferred to all other substances as epi- 
spastics, and they are used for all the medicinal purposes that are 
within the range of this class of medicines. 

The following are the forms under which Spanish flies are used 
externally : — 

Ceratum cantharidis (cantharides cerate), commonly known as 
blistering cerate, is made by mixing powdered cantharides (35 
parts) with melted wax and resin (each 20 parts) and lard (25 
parts). This is the preparation usually employed to raise a 
blister. It can be applied without the aid of heat, and should be 
spread on soft leather, or linen, or adhesive plaster, and covered 
with gauze or unsized paper. From four to twelve hours is the 
period for which the cerate should be applied ; on the scalp a 



* Gaz. Hebdom., 1874, 2d ser., p. 438. 

f Taylor's " Med. Jurisprudence," I, 1883, p. 350. % Ibidem. 



5 l6 MATERIA MEDICA TOPICAL MEDICINES. 

longer application may be required. For an ordinary impres- 
sion, and where the cutaneous sensibility is not impaired by 
disease, it need not be kept on more than four or five hours. 
In cases of children less time is required for the application 
of the cerate, and great caution is necessary in applying it to 
infants. A poultice of bread and milk or flaxseed meal should 
be afterwards applied, which usually produces vesication if the 
action of the blister has not extended beyond rubefaction. If 
it be desirable to heal the blistered surface immediately, cotton- 
wadding or cerate may be placed over it, after the serum has 
been allowed to escape. To maintain the discharge, the cuticle 
should be removed and basilicon ointment applied ; if the sur- 
face require further irritation, the ointments of savine, mezereon 
or cantharides may be used. The open or perpetual blister is, 
however, not required for ordinary antiphlogistic purposes ; and 
indeed, as a general rule, the blistered surface should be allowed 
to heal as speedily as possible. In case of excessive pain, a poul- 
tice of bread-crumb and lead-water, with morphine sulphate gr. 
Y^ mixed in it, or a starch-poultice or lime-liniment, is a sooth- 
ing application. Goulard's cerate is an excellent application to 
heal obstinate ulcers from blisters. For the relief of strangury, 
diluents and diuretics are proper, as flaxseed tea, with sweet 
spirit of nitre, decoction of uva ursi, etc., and an opium or mor- 
phine suppository if the symptoms are severe. Ceratum extracti 
cantharidis {cerate of extract of cantharides) differs chiefly from 
the common cerate in being made with an alcoholic extract of 
the flies instead of the flies themselves ; it is said to be more 
active than the former preparation. To prepare it, 30 parts of 
cantharides are to be percolated to exhaustion with stronger 
alcohol, evaporated to the consistence of a soft extract, and 
mixed with 15 parts of resin, 35 parts of yellow wax and 35 
parts of lard (melted together). Ethereal, alcoholic, hydro- 
alcoholic and watery extracts of cantharides have been suggested 
as substitutes for the blistering cerate, and, mixed with wax and 
spread on thin cloth or paper, are termed vesicating taffetas. Lini- 
mentum cantharidis {liniment of cantharides) consists of cantharides 
(15 per cent) dissolved in oil of turpentine ; it is a prompt stimu- 
lating liniment, and may be applied to the skin to prepare it for 
the action of the blistering cerate. Collodium cum cantharide 



IRRITANTS WATER OF AMMONIA. 517 

(collodion ivith cantharides), or cantharidal collodion, is made by 
percolating cantharides with commercial chloroform until the 
cantharides are exhausted, evaporating the liquid thus obtained, 
and dissolving the residue in flexible collodion. It should be 
kept in a cool place. It furnishes a very convenient mode of 
blistering a small irregular surface, and is applied by means of 
a camel's-hair brush, in successive layers, which should be cov- 
ered with a piece of oiled silk. Charta cantharidis {cantharides 
paper) is made by boiling gently a mixture of 8 parts of white- 
wax, 3 parts of spermaceti, 4 parts of olive oil, 1 part of Canada 
turpentine and cantharides each, in 10 parts of water, and, after 
filtration, passing strips of paper over the surface of the mixture, 
which, when dry, are cut into rectangular strips. The canthari- 
dal preparations are used externally to promote the growth of 
the hair. Dupnytreri s Pomatum is a tincture made with can- 
tharides, 5j, and alcohol, f Sj, incorporated with nine parts of lard. 

Cantharis Vittata {Potato-Flies) (not officinal). Several spe- 
cies of cantharis are found in the United States, and are good 
substitutes for C. vesicatoria. C. vittata, or the Potato-Fly , is 

Fig. 42. 




CANTHARIS VITTATA. 



most used. It resembles the Spanish fly in shape, but is rather 
smaller, being about six lines in length, with black elytra or 
wing-cases, and inhabits chiefly the potato plant. It contains 
cantharidin. 

AQUA AMMONIA WATER OF AMMONIA. 

Stronger Water of Ammonia (vide p. 212) may be used for the 
purpose of speedy vesication. It is more rapid, but much more 
painful, than cantharides. Five parts of this, mixed with spirit 



5 l8 MATERIA MEDICA TOPICAL MEDICINES. 

of camphor, 2 parts, and spirit of rosemary, 1 part, has been used 
as a prompt vesicant, under the name of Granville s Lotion. A 
piece of flannel, saturated with the liniment, is applied to the skin, 
which it will generally blister in from three to ten minutes. Gon- 
drefs Vesicating Ointment is made by melting together 2 parts of 
expressed oil of almond and 32 parts of lard, and adding to this 
mixture 17 parts of stronger water of ammonia; it will vesicate 
in ten minutes. Ammonia is applied locally as an antidote to 
the poison of venomous reptiles and insects. 

SUPPURANTS. 
OLEUM TIGLII CROTON OIL. 

Croton Oil {vide p. 353), when rubbed on the skin, produces 
rubefaction, accompanied by a pustular eruption. It is used as 
an application to the throat and chest in subacute or chronic 
laryngeal and bronchial affections, and to rheumatic joints. It 
may be applied undiluted, or mixed with one, two or three parts 
of olive oil, or oil of turpentine, according to the susceptibility of 
the skin. 

UNGUENTUM ANTIMONII ANTIMONIAL OINTMENT. 

This ointment consists of 1 part of antimonium and potassium 
tartrate mixed with 4 parts of lard. The peculiar eruptive 
effects of tartar emetic have been already noticed (p. 241). It 
may be used in the form of ointment or solution, in the same 
cases as croton oil, but it is a more painful and permanent 
application. 

ESCHAROTICS. 

Escharotics (from W^a/>a, an eschar), called also Cauterants, 
are medicines which destroy the structure and vitality of the 
parts to which they are applied. The eschar which their appli- 
cation produces is followed by inflammation and suppuration 
of the surrounding tissues, by which the slough is separated 
from the living parts. 

They are employed — 1. To effect the destruction of morbid 
growths, warts, condylomata, polypi, fungous granulations, etc. 
2. To destroy the virus of rabid and venomous animals, and of 
chancres and malignant pustules, and to prevent their absorp- 
tion. 3. For the cure of violent inflammation, by their substi- 



IRRITANTS POTASSA. 5 19 

tutive action, as when they are applied to the mucous or 
cutaneous surfaces, in gonorrhceal ophthalmia, erysipelas, poi- 
soned parts, carbuncles, etc. 4. To stimulate indolent sinuses, 
ulcers, etc., where their influence is also of a substitutive char- 
acter. 5. To form issues. 6. To remove morbid heterologous 
growths, as lupus, cancer, warts, etc. 

ARGENTI NITRAS FUSUS FUSED SILVER NITRATE. 

Lunar Caustic (described at length p. 201) is the most 
commonly employed of the caustics. It has the advantage of 
not liquefying when applied, and its action is therefore con- 
fined to the parts with which it is brought in contact, and is 
superficial. It is used to remove fungous granulations in 
wounds and ulcers, to destroy warts, to alter the action of 
indolent ulcers, sinuses, and fistulae, to subdue the inflamma- 
tory action of paronychia, erythema, etc., to arrest the pro- 
gress of erysipelas and cancrum oris, to cut short variolous 
pustules, to cure skin diseases by a substitutive action, and 
in inflammations of mucous membranes. In dilutions of vari- 
ous strengths it is resorted to in every variety of inflamma- 
tion of the mucous membranes ; when a full impression is 
desired, a solution of gr. xx-xxx in distilled water fSj may 
may be employed; for ordinary purposes, gr. ij to water fSj. 
The diluted silver nitrate (vide p. 201) is also used externally. 

POTASSA. 

Caustic Potassa is prepared by the rapid evaporation of 
Solution of potassa (vide p. 457) with heat. While in the state of 
fusion, it is received into cylindrical iron moulds, and it occurs 
in the form of sticks, of a brownish, grayish or bluish color, 
a fibrous fracture, the odor of slacking lime, and a caustic, 
urinous taste. It dissolves in alcohol and in less than its 
weight of water, and attracts both moisture and carbonic acid 
rapidly from the air. It is more or less impure as found in 
the shops. By digestion in alcohol it is freed from impurities 
insoluble in this menstruum (as the potassium carbonates), and 
it may be afterwards obtained quite white and pure by evapo- 
ration; it is then termed alcoholic potassa. The potassa of the 
shops is a hydrate, consisting of the elements of water and potassa. 



520 MATERIA MEDICA TOPICAL MEDICINES. 

Effects and Uses. — It is the most powerful known escharotic, 
and differs from lunar caustic in extending its action to a con- 
siderable depth beneath the surface to which it is applied. It 
is used chiefly to form issues, to destroy the virus of chancres 
and of malignant pustules and that from the bites of venomous 
reptiles and rabid animals, and sometimes also to arrest the 
sloughing of carbuncles, and, from its deep-reaching action, it 
is preferred to lunar caustic in these cases; applied to the 
cutaneous surface, in cases of phlegmon, threatened carbuncle, 
etc., it will sometimes avert the progress of inflammation. It 
is a good application in cases of rodent ulcer, the superficial 
forms of epithelioma generally, and in lupus, the diseased tissue 
having been removed with the knife as thoroughly as possible 
previous to the application of the caustic. When it is applied 
to the skin, this should be covered with linen spread with 
adhesive plaster, having a hole the size of the spot to be 
cauterized. A solution (5iss to fSij of water) is used as a 
rubefacient. 

Potassa cum Calce {Potassa with Lime) is prepared by rubbing 
up equal parts of potassa and lime. It is a grayish-white pow- 
der, which is sometimes made into a paste with a little alcohol, 
and is termed Vienna Paste ; it has been also formed into sticks. 
The presence of lime renders this a milder, less deliquescent and 
more manageable caustic than potassa ; it is a favorite application 
to chancres. 

SODA. 

Caustic Soda is prepared by the rapid evaporation of Solution 
of soda (vide p. 459) until ebullition ceases and the soda melts ; 
when it has congealed, it is broken into grayish-white, opaque, 
brittle fragments, which are very corrosive, very soluble in water, 
soluble in alcohol, and deliquescent, though, unlike potassa, it 
does not become permanently liquid, but after a time effloresces. 
It is employed for the same cauterant purposes as potassa, than 
which it is somewhat milder in action. London Paste is made by 
rubbing up equal parts of soda and lime. 

ACIDUM CHROMICUM CHROMIC ACID. 

Chromic Acid (Cr0 3 ) is obtained by the reaction of sulphuric 
acid upon a solution of potassium bichromate. It is properly 



IRRITANTS BROMINE. 521 

chromic anhydride, and occurs in the form of anhydrous, deep- 
red, needleform crystals, of an acid, metallic taste ; they are 
deliquescent, and very soluble in water, with which they form an 
orange-yellow solution. 

Effects and Uses. — This is an eschar otic of great power, decom- 
posing the tissues by its rapid oxidizing action. Used in the 
form of paste, or solution more or less diluted, it is a most effi- 
cacious application to lupus, morbid growths and excrescences, 
as syphilitic condylomata, etc., and is unequalled as an agent for 
removing warts from the hands. It gives less pain than other 
caustics ; but it is to be used with caution, especially near deli- 
cate parts like the eye, as its action is deeply penetrating. The 
solution may be made of the strength of from gr. ioo-Sj to foj 
of water ; and is to be applied by means of a pencil or glass rod. 
Solutions of chromic acid in glycerin, which have been used, are 
liable to explode if the reagents are mixed too quickly ; the gly- 
cerin should be added drop by drop. 

ACIDUM ARSENIOSUM ARSENIOUS ACID. 

This is a powerful escharotic (vide p. 439), and is occasionally 
applied in lupus, onychia maligna, cancerous ulcers, and to 
change the action of indolent sinuses; but its use is attended 
with danger. When used, it should be applied freely, as a 
large amount causes such rapid death of the tissues that absorp- 
tion is rendered impossible. It may be diluted with one or more 
parts of sulphur. 

BROMUM BROMINE. 

Bromine (Br) is an elementary body, bearing close chemical 
affinities to iodine. It is a constituent of sea-water and of many 
mineral springs. In Europe it is obtained principally from the 
mother liquors of the salt mines of Stassfurt, in Germany ; in 
this country, from saline springs in western Pennsylvania, Ohio, 
and West Virginia, in which it exists as magnesian bromide. It 
is a volatile, dark-red liquid (sp. gr. 3), of a caustic taste and a 
strong, disagreeable smell, sparingly soluble in water, more solu- 
ble in alcohol, and still more so in ether. Its effects on the system, 
considered chemically, are similar to those of chlorine. It de- 
composes hydrogen compounds, forming hydrobromic acid, and 
separating the elements combined with the hydrogen ; hence it 



522 MATERIA MEDICA TOPICAL MEDICINES. 

is a deodorant and disinfectant. On account of these properties, 
and because it is a liquid, it is a severe, rapid and thorough 
caustic. The vapor is intensely irritant to the mucous mem- 
brane, causing, when inhaled in sufficient quantity, laryngitis, 
bronchitis, and pneumonia. In the stomach it is a corrosive 
poison. Snell* reports a case in which §j killed an adult in 
seven hours. The symptoms were immediate dyspnoea, epigas- 
tric pain, trembling of the hands and great anxiety. In acute 
coryza, chronic nasal catarrh, ozaena, and hay asthma, a small 
quantity of a solution (5ss) in alcohol (f§iv) may be inhaled from 
a wide-mouthed vial with good result. 

Locally, in hospital gangrene, after removing the slough, it is 
the best escharotic. It is also used as a caustic in chancre and 
various forms of cancer, especially carcinoma uteri. 

ZINCI CHLORIDUM ZINC CHLORIDE. 

This is also a powerful escharotic (vide p. 198); and, in addi- 
tion to its corrosive properties, it appears to exercise a greater 
influence over the vital action of neighboring parts than some 
of the other caustics. The separation of its eschar leaves very 
healthy and vigorous granulations, and it is one of the best appli- 
cations that can be made to intractable, indolent ulcers and 
sinuses. It will sometimes cure lupus. 

LIQUOR HYDRARGYRI NITRATIS SOLUTION OF MERCURIC NITRATE. 

This preparation {vide p. 423), termed also the acid nitrate of 
mercury, is a valuable caustic application to malignant ulcers, 
hospital gangrene, chancre, etc. 

HYDRARGYRI CHLORIDUM CORROSIVUM CORROSIVE CHLORIDE OF 

MERCURY. 

Corrosive Sublimate is more frequently used as a stimulant or 
antiseptic wash than as a caustic (see p. 416). 

POTASSII BICHROMAS POTASSIUM BICHROMATE. 

This salt, already noticed under the head of Alteratives (vide 
p. 454), is a good caustic application, in saturated solution or in 
powder, to syphilitic and other vegetations. 

* N. Y.Journ. of Med., Nov., 1850, p. 179. 






IRRITANTS GREEN SOAP. 523 

ACIDA MINERALIA MINERAL ACIDS. 

The mineral acids {vide p. 169) are powerful escharotics, but 
are inconvenient for many uses, on account of the extension of 
their action beyond the point of application. On the other hand 
they can be made to reach the bottoms of sinuses and fistulae, 
which are inaccessible to the solid caustics. Nitric acid, for such 
purposes, has no equal in the list of escharotics ; it is used also 
to destroy warts. Properly diluted, the mineral acids are em- 
ployed in injections, gargles, etc. ; and in the form of ointment, in 
skin diseases. . 

Copper Sulphate {vide p. 196) and Alum (vide p. 203) are 
mild escharotics, but are used chiefly to remove fungous granu- 
lations in ulcers. The actual cautery and moxa have been alluded 
to under the head of Heat (vide p. 39). 

Under " Irritants " may be considered sapo viridis and chrysa- 
robin, two remedies which, although not used as escharotics, are 
applied to the skin in certain of its diseases for their local irritant 
effect. The former has decided caustic properties, due to the 
potassa which it contains. 

Sapo Viridis — Green Soap — is a soft, greenish, jelly-like 
soap, prepared from potassa and the fixed oils, very soluble in 
water and alcohol. Like all soaps, especially soft soaps, it is a 
mild caustic, and was introduced into medical practice by Pro- 
fessor von Hebra, in the treatment of various cutaneous affections, 
especially of the scaly variety. It is useful to remove the infil- 
trated patches of eczema rubrum, and for this purpose should be 
well rubbed in with a piece of flannel until all traces of the soap 
have disappeared, when the flannel is wet with water and the 
rubbing again performed ; the surface should be then washed 
with clean water and carefully dried, when it will be found red 
and angry-looking, with here and there a minute point from which 
serum is oozing. Between the applications ointments are to be 
applied. Sapo viridis is also much used to remove scales and 
crusts, as in psoriasis, seborrhoea, and in various other skin 
affections. In tinea versicolor it will often effect a prompt cure, 



524 MATERIA MEDICA TOPICAL MEDICINES. 

and is highly useful to cleanse the skin in parasitic affections 
before the application of a germicide. 

Tinctura saponis viridis (tincture of green soap) consists of 65 
per cent, of green soap and 2 per cent of oil of lavender dissolved 
in alcohol. It is milder in its action than green soap, and is used 
to fulfil the same indications. 

Chrysarobinum — Chrysarobin, often improperly called 
Chrysophanic Acid — consists of a mixture of principles ex- 
tracted from araroba or goa-powder, a substance found in the 
clefts of Andira araroba {Nat. Ord. Leguminosae). It has also 
been obtained from different species of rhubarb. It is an orange- 
yellow powder, crystallizing in needles, insoluble in water, only 
slightly soluble in alcohol and chloroform, readily so in ether, 
and possesses neither taste nor smell. 

Effects and Uses. — When applied locally \ it is an irritant to the 
skin, causing irritation and inflammation accompanied with 
swelling, itching, pain, heat, and sometimes a papular eruption, 
especially when applied about the head and face. The action 
is not always limited to the part to which it is applied, but ex- 
tends to the healthy skin in the vicinity. Observers do not 
agree respecting the internal effects of this drug. It is princi- 
pally used as an external application in cases of skin disease 
due to vegetable parasites, for which it is an excellent remedy, 
and in psoriasis, in which disease the scabs soon disappear and 
the patches become white under its use. In the treatment of 
ringworm the parts should first be cleansed with sapo viridis in 
order to facilitate contact of the remedy with the parasite, and 
then the following solution should be applied : 1^ Chrysarobini, 
gr. v-x; chloroformi, fSj. M. S. — Shake before using. After 
this is dry, paint on, as a protective, liquor gutta-perchae. This 
solution of chrysarobin should be applied every few days until 
the parasite is effectually destroyed. Alexander * reports excel- 
lent results in sixty cases of ringworm of the scalp from the use 
of a 10 per cent, solution of chrysarobin in gutta-percha solution. 
It must not be forgotten that chrysarobin produces a permanent 

* Journ. of Cutaneous and Venereal Diseases, 1885, p. 2sZ- 



DEMULCENTS. 525 

stain upon clothing. It stains the skin yellow, and should never 
be applied to the head or face on account of the liability to 
swelling and oedema of the eyelids. It has also been used inter- 
nally. The ointment (made by rubbing 10 parts of chrysarobin 
with 90 parts of benzoinated lard) may be used. 



ORDER III. DEMULCENTS. 

Demulcents, or Lenitives, are medicines' which soften and 
relax the tissues, and, when applied to irritated or inflamed 
surfaces, diminish heat, tension, and pain. They consist chiefly 
of gum or mucilage, or of a mixture of these with saccharine 
and farinaceous substances, and form with water viscid solu- 
tions. Their constitutional effects are principally nutritive, 
though perhaps, to some extent, they relieve irritation in distant 
organs by modifying the acridity of the secretions. Demulcent 
solutions are administered internally — I. To sheathe and pro- 
tect the gastro-enteric surface from the injurious effects of irri- 
tating substances, particularly acrid poisons. 2. To relieve irri- 
tation and inflammation of the alimentary canal, as in gas- 
tritis, enteritis, diarrhoea, and dysentery ; and for this purpose 
they may be administered by either the mouth or rectum. 3. 
In catarrhal affections, in which they are probably useful in 
part by the transmission of their lubricating and soothing effects 
on the fauces and oesophagus by reflex action to the laryngeal 
and bronchial membranes, and in part by modifying the acridity 
of expectorated matters. 4. In affections of the urinary passages, 
as ardor urinae, cystitis, etc., and in these cases they act chiefly 
by diminishing the acridity of the secretions. 5. As agreeable 
drinks, to quench thirst and promote the action of the secreting 
and exhaling organs in febrile affections. Their effects in these 
cases are owing partly to the water which they contain, to which 
they are added merely for the sake of flavor, and partly also 
to the nutriment which they furnish. When administered with 
the object of increasing the proportion of the fluid parts of the 
blood, demulcents are termed Diluents. 6. As light diet for 
the sick. 7. For pharmaceutical purposes, to suspend sub- 
stances insoluble in water, etc. 

Externally, mucilaginous solutions are employed extensively 



5 2D MATERIA MEDICA TOPICAL MEDICINES. 

to relieve the heat, swelling and pain of inflammation, wounds, 
burns, etc. ; to hasten suppuration where inflammation is too 
far advanced for resolution ; to cleanse foul and scabby ulcers ; 
to promote suppuration from granulating surfaces, etc., etc. 
When applied externally, this class of medicines is termed 
emollients. Mucilaginous and amylaceous substances are 
applied to inflamed and ulcerated parts, mixed with water so as 
to form soft masses, termed — 

Cataplasms or Poultices, which are useful vehicles for the 
application of heat and moisture. When applied to a healthy 
part, a poultice acts as a sedative and relaxant. In the early 
stages of inflammation it lessens the amount of blood at the 
seat of morbid action, by dilating the cutaneous vessels, and 
prevents stasis and the migration of the white corpuscles : after 
stasis has taken place and migration has commenced, it favors 
the formation of pus, probably by aiding migration through the 
relaxing effect it exerts on the vessels, and also by promoting 
cell-proliferation : applied to a wound, it stimulates the forma- 
tion of embryonic and granulation tissue, from its influence 
over cell-proliferation (H. M). If the use of poultices be too 
long persisted in, the part becomes pale, sodden, relaxed and 
shrivelled, and even devitalized, in extreme cases. 

Poultices are used in the early stages of acute inflammation of 
internal viscera for their antiphlogistic effects : thus, the abdo- 
men may be covered with a large poultice in the early stages of 
peritonitis, if not objectionable on account of its weight, and a 
jacket- poultice may be used with excellent effect in the early 
stages of bronchitis, pneumonitis or pleuritis, the chest being 
completely surrounded by the poultice. They are sometimes 
used for the same purposes in external inflammations. For their 
effects on pus-formation and cell-proliferation, they are useful in 
external inflammation when suppuration can no longer be pre- 
vented, as in furuncles, carbuncles, etc., and are also applied to 
granulating surfaces, as in wounds or ulcers. As they stimulate 
the granulation-process, their application should be discontinued 
as soon as the granulations reach the level of the surrounding 
skin. 

When applied to a granulating surface, or, indeed, to an open 
wound of any kind, the poultice should be thoroughly antisepti- 



DEMULCENTS WATER. 527 

cised, as by admixture with a solution of corrosive sublimate, 
else it forms an excellent nidus for the development of various 
forms of protophytes, the multiplication of which will be accel- 
erated by the heat and moisture. 

In the treatment of gangrenous, sloughing or foul-smelling 
ulcers or wounds, yeast or charcoal is often added to the poultice, 
to aid in the separation of the slough or to correct the fcetor. 
Poultices may be medicated with lead-water and laudanum, or 
other substances, if it be desired to abate the inflammatory pro- 
cess. 

AQUA WATER. 

Water has important medicinal as well as pharmaceutical 
uses. The Pharmacopoeia directs it to be employed in the 
purest attainable state, which is rain or snow water ; for pharma- 
ceutical purposes, distilled water (aqua destillata) should be used. 
Pure water is a transparent liquid, without color, taste or smell ; 
but owing to its extensive solvent powers, in the natural state it 
is more or less contaminated with foreign matters. It is a com- 
pound by volume of 2 atoms of hydrogen and I of oxygen 
(H 2 0). 

Effects and Uses. — Water is necessary for the solution and 
digestion of our food; in either insufficient or excessive amount 
it may prove injurious. Thus, without a proper supply of water, 
not only the absorption of soluble matters in the stomach is 
interfered with, but also the passage of undigested substances 
into the intestines ; and besides, some articles, as sugar, do not 
undergo the fermentation necessary for digestion. On the other 
hand, an excess of water taken into the stomach impairs diges- 
tion by over-dilution of the gastric juice, and will occasion the 
acetous fermentation of saccharine articles. Water is eliminated 
from the system by the intestines, skin and lungs, but chiefly by 
the kidneys ; and it is believed, in large amounts, to increase not 
only the water, but the solid constituents, of the urine ; hence 
its use as a diuretic. As it promotes both the metamorphosis 
and construction of tissue, it may produce a valuable alterative 
effect in morbid taints of the system, and prove a useful adjunct 
to more active eliminative agents. Water is the basis of all 
drinks administered to relieve the thirst of fever and moderate 
the undue viscidity .of the blood which is present in inflamma- 



528 MATERIA MEDICA TOPICAL MEDICINES. 

tion ; it must not be permitted in excess, however, as undue 
amounts may produce nausea, flatulence and even vomiting and 
diarrhcea. The uses of water, as an external agent, have been 
noticed under the head of heat and cold. 

Carbonic Acid Water (H 2 C0 3 ) (unofficinal). Water impregnated 
with a quantity of carbonic acid equal to five times the bulk of 
the water (which may be obtained from sodium bicarbonate or 
from marble, by means of diluted sulphuric acid) often proves 
useful in allaying nausea and vomiting, and is also a good vehicle 
for some of the neutral purgative salts which are of unpleasant 
taste. M. Jacquemaire * has recently called attention to the 
value of carbonic acid water, under a pressure of four or five 
atmospheres, to sterilize aqueous solutions of the salines, the 
pyrophosphate of iron and pepsin. 

ACACIA. 

Acacia, or Gum arabic, is a gummy exudation from Acacia 
Verek and other species of Acacia {Nat. Ord. Leguminosse), 
thorny or prickly trees or shrubs of Africa and Arabia. Con- 
siderable gumf is collected by the Somali tribe on the N. E. coast 
of Africa, who obtain it by incision. The gum exudes either 
through natural cracks in the bark or through incisions made to 
facilitate its exudation, and hardens on exposure. Several com- 
mercial varieties are known, as Turkey, Barbary, Senegal, India, 
etc, of which the most important are Turkey gum and Senegal 
gum. 1. Turkey gum (Kordofan gum) is the kind usually found in 
the shops. It consists chiefly of small, irregular fragments, inter- 
spersed with larger pieces of a whitish color, which is sometimes 
slightly tinged with yellow or reddish-yellow. It is purer than 
other varieties, and is generally characterized by innumerable 
minute fissures pervading its substance. 2. Senegal gum occurs 
in roundish or oval unbroken pieces, sometimes whitish, but gen- 
erally yellowish, reddish or brownish-red. 3. Barbary gum comes 
from Morocco, and consists of two kinds, one resembling the 
Turkey, the other the Senegal gum. 4. India gum, though 
brought from India, is collected on the northeastern coast of 



* Bull. Gen. de Therap., Aout isieme, tf&% % 
f Journ. of Pharmacy, xii, 226. J. Vaughan. 






DEMULCENTS ACACIA. 5 20, 

Africa, the Somali district, and in the ports of the Red Sea. It 
is in pieces of varying size, color and quality, and is often con- 
taminated with Bassora gum, which is insoluble in water. All 
the varieties are more or less transparent, hard, brittle and pul- 
verizable, and form a white powder. They are inodorous, with 
a feeble, slightly sweetish taste, and when pure dissolve wholly 
in the mouth. When kept in a dry place they undergo no change 
by time. 

Chemical Constituents. — Acacia consists almost wholly of a pe- 
culiar proximate principle, usually termed Gum, but latterly des- 
ignated by chemists as Arabin. It is soluble in hot or cold water, 
forming a viscid solution called mucilage, and is insoluble in 
alcohol, ether and the oils. Alcohol precipitates gum from its 
aqueous solution ; lead subacetate (which is a delicate test), lead 
nitrate and solution of iron chloride also precipitate it from so- 
lution. Arabin {gummic or arabic acid) (C^H^On) is combined 
with about 3 per cent, of lime, forming a soluble salt, calcium 
gummate. Gums of inferior transparency and solubility contain 
bassorin, an inert principle, insoluble in water and alcohol. 

Effects and Uses. — Acacia is extensively employed, internally, 
as a demulcent in gastro-enteric inflammation, diarrhoea, dysen- 
tery, cases of acrid poison, etc. ; as a lubricant to the fauces in 
catarrhal affections, and also as a vehicle for anodynes and ex- 
pectorants in cough mixtures; and as a diluent in fevers and in- 
flammatory cases. It is not now considered to be digestible, 
and can scarcely rank (as formerly supposed) with nutrients. It 
is usually administered in solution (§j to boiling water Oj, to be 
given when cool) ; in cases of irritation of the fauces it may be 
taken into the mouth and allowed slowly to dissolve. For phar- 
maceutical purposes acacia is much used to suspend insoluble 
substances in water, and in making pills and lozenges. Mucilago 
acacice {mucilage of acacia) is used in making pills, emulsions, 
etc. ; it becomes sour by keeping. Syrupus acacice {syrup of acacia) 
(25 per cent, of mucilage of acacia mixed with 75 per cent, of 
syrup) is used for the same purpose. Mistura amygdalce {almond 
mixture) is made by dissolving a mixture of 6 parts of blanched 
sweet almonds, 1 part of acacia, and 3 parts of sugar, in 100 parts 
of distilled water ; it is a pleasant demulcent and vehicle for other 
medicines. By dissolving equal parts of sugar and acacia in 
34 



530 MATERIA MEDICA TOPICAL MEDICINES. 

water and evaporating, an agreeable demulcent is obtained, 
known as gum pectoral, which is sold as an imitation of jujube 
paste. 

TRAGACANTHA TRAGACANTH. 

This is a gummy exudation from Astragalus gummifer and 
other species of astragalus {Nat. Ord. Leguminosae), small shrubs 
found in Persia, Asia Minor and countries bordering on the 
Levant, with numerous branches covered with imbricated scales 
and beset with spines. Tragacanth exudes spontaneously in the 
hot weather, and hardens, as it exudes, in forms of various shapes. 
It occurs in irregular tortuous flakes or filaments, of a whitish or 
yellowish-white, or occasionally a slightly reddish color, some- 
what translucent, resembling horn in appearance. It is hard and 
fragile, but very difficult of pulverization, and has no smell and 
very little taste. When heated with water it swells and forms a 
paste, and if agitated with an additional quantity it forms a uni- 
form mixture, from which it is, however, almost entirely depos- 
ited upon standing a day or two. It contains two constituents, 
one soluble in water, resembling arabin, but not identical with it, 
combined with calcium, the other termed tragacanthinifZ^^iA^Oi^). 

Effects and Uses. — Tragacanth is seldom given internally, on 
account of its difficult solubility. It is useful in suspending 
heavy insoluble powders, and answers better than gum arabic to 
impart consistence to lozenges. Mucilago tragacanthce {inucilage 
of tragacantfi) — tragacanth 6 parts, with glycerin 18 parts, in 
water enough to make the whole weight 100 parts — is used in 
making pills and troches, and for the suspension of heavy insol- 
uble metallic substances. 

LINUM FLAXSEED. 

This is the seed of Linum usitatissimum, or Common Flax 
(Nat. Ord. Linacese), an annual plant, of the height of two feet, 
originally a native of eastern countries, but naturalized in Europe, 
and cultivated in all parts of the world. The seed and oil are 
both officinal. The seeds are about a line in length, oval, smooth 
and glossy, of a brown color externally and yellowish-white 
within ; a variety of flax is cultivated in Ohio, the seeds of which 
are greenish-yellow. Flaxseeds are inodorous, and have an oily, 
mucilaginous taste. They contain 30 or 35 per cent, of fixed oil, 



DEMULCENTS FLAXSEED. 53 I 

a large proportion of mucilaginous matter, vegetable albumen, etc. ; 
the mucilaginous matter, which is found chiefly in the husks ol 
the seeds, consists, about one-half, of a principle soluble in cold 
water, resembling arabin, and about one-third, of a principle in- 
soluble in water. The oil {oleum lini or linseed-oil} is obtained by 
expression from the interior part of the seeds ; it is laxative in 
the dose of f5j-ij, but it is chiefly used externally, mixed with an 
equal amount of lime-water, as in the old " carron oil." 

Effects and Uses. — Decoction is an improper mode of prepar- 
ing a demulcent solution of flaxseed, as boiling extracts part of 
the oil ; but it answers very well when it is used as a laxative 



Fig. 43- 




LINUM USITATISSIMUM. 



enema. Ground flaxseed forms a much-used emollient poultice 
(vide p. 526), which is prepared by gradually adding boiling water 
to flaxseed meal in a vessel previously heated, and constantly 
stirring until it makes a smooth dough of proper consistence, 
which is then spread on muslin and a piece of gauze or mosquito- 
netting placed upon it, to prevent it from adhering to the skin. 
After the poultice is applied, it should be covered with oiled silk 
or waxed paper, to Tetain the heat and prevent evaporation. The 
cake remaining after the expression of the oil, retains the mucil- 
aginous and albuminous constituents of the seed, and forms a 



532 MATERIA MEDICA TOPICAL MEDICINES. 

food for cattle, under the name of oil-cake. This is used for 
making poultices, but it is inferior to the meal made from the 
seeds which have not been deprived of their oil. 

OLEUM GOSSYPII SEMINIS — COTTON-SEED OIL. 

This is a fixed oil expressed from the seed of Gossypium 
herbaceum (vide p. 267) and other species of Gossypium. It is 
subsequently purified by being bleached with alkalies and with 
sulphuric acid, and is finally obtained as a clear, pale-yellow oily 
liquid, without odor and having a bland, nut-like taste. It con- 
tains olein and palmitin. It is very bland, and may be used as a 
substitute for almond or olive-oil. It is used externally as an 
ingredient of linimentum ammonia (vide p. 510), linimentum cal- 
cis (p. 463), linimentum camphorce (vide p. 1 1 8), and linimentum 
plumbi subacctatis (vide p. 193). 

ULMUS SLIPPERY-ELM BARK. 

This is the inner bark of Ulmus fulva, or Slippery-Elm (Nat. 
Ord. Urticaceae), a lofty indigenous tree which is found through- 
out the United States north of Carolina, and grows most abun- 
dantly west of the Allegheny Mountains. The inner bark is 
prepared for use by the removal of the epidermis ; it is found in 
the shops in long flat pieces, of a fibrous texture, tawny on the 
outer surface and reddish on the inner, of a peculiar but not un- 
pleasant smell and a very mucilaginous taste. It affords a light 
grayish, fawn-colored powder. A large quantity of mucilagin- 
ous matter 'is contained in it, which is yielded readily to water, 
also some tannic acid. Much of the bark lately brought into the 
market is inferior, containing but little mucilage ; it is less fibrous 
and more brittle than the genuine bark. 

Effects and Uses. — Slippery-elm bark is a valuable demulcent, 
extensively and advantageously employed in dysentery, diarrhoea, 
genito-urinary diseases, catarrhs, etc. It is also highly nutritious. 
Externally it is an excellent emollient application, in the form 
either of infusion or of poultice made with the powder. It has 
been also recommended for the dilatation of strictures and fistu- 
lae, and, made into a spongy mass, as a tent to dilate the os uteri. 
The infusion — mucilago ulmi (mucilage of slippery-elm bark) (2 
parts to water 100 parts) — may be used ad libitum. 



DEMULCENTS OIL OF BENNE. 533 

SASSAFRAS MEDULLA SASSAFRAS PITH. 

Sassafras pith is the pith of the stems of Sassafras officinale 
(vide p. 364). It occurs in light, spongy, whitish, slender, cylin- 
drical pieces, of a mucilaginous taste. It abounds in a gummy 
matter, which it yields readily to water, forming a limpid, viscid 
mucilage. This mucilage (2 parts to water 100 parts) — is a plea- 
sant demulcent drink in dyspeptic, nephritic and catarrhal affec- 
tions, and is much used as a soothing application in ophthalmia. 

ALTH.EA. 

The root of Althaea officinalis (Nat. Ord. Malvaceae), com- 
monly known as Marshmalloiv, an herbaceous European plant, 
occasionally found, too, on the borders of salt marshes in our 
own country, with ovate, soft, velvety, crenate leaves and pretty 
flesh-colored flowers, is much used in Europe as a demulcent. 
The roots of other Malvaceae are often substituted for those ol 
the officinal roots. These are imported in pieces, three or four 
inches in length, of nearly the thickness of the finger, light, 
easily broken, white externally, of a peculiar faint smell and a 
mild, mucilaginous, sweetish taste. The chief constituents of 
marshmallow are mucilage and starch, the former soluble in cold 
water, the latter requiring boiling water. It contains also aspar- 
agin (C4H 8 N 2 03,H 2 0), a crystalline principle found in asparagus 
shoots and other plants. 

Uses. — Marshmallow decoction is employed as a demulcent in 
inflammatory and irritated conditions of the mucous membranes 
of the respiratory, digestive and urinary organs, and poultices 
made of the bruised or powdered root are used externally. The 
syrup is officinal. 

OLEUM SESAMI OIL OF BENNE. 

This is a fixed oil expressed from the seed of Sesamum 
indicum (Nat. Ord. Pedaliaceae), an annual plant, growing to the 
height of four or five feet, with ovate-lanceolate, lobed leaves, 
reddish-white axillary flowers, and an oblong capsule containing 
small oval yellowish seeds. It is a native of India, but is now 
raised throughout Asia and in Egypt and Italy, also in South 
Carolina and in the neighborhood of Philadelphia. The seed 
contains a fixed oil, and the leaves yield to cold water a large 



534 



MATERIA MEDICA TOPICAL MEDICINES. 



quantity of mucilage resembling that of sassafras pith. This is 
a highly-esteemed demulcent drink, used in cholera infantum and 
infantile bowel complaints. The seeds are eaten as food by the 
negroes in Carolina, in broths, puddings, etc. The oil, which 
is inodorous, of a bland, sweetish taste, and keeps well, may be 
used internally or externally as a substitute for olive-oil. 

CYDONIUM. 

This is the seed of Cydonia vulgaris or Quince tree {Nat. Ord. 
Rosaceae), a native of Europe, but cultivated in the United States 
for the fruit. The seed are ovate, angular, reddish-brown exter- 
nally, white within, inodorous, insipid, and abound in mucilage. 
They are used, principally, externally, in solution (inucilago cy- 
donii), two parts to water ioo parts; but may be given internally 
as a demulcent, in gastro-intestinal or bronchial inflammations. 

GLYCYRRHIZA. 

Glycyrrhiza or Liquorice Root is the root of Glycyrrhiza glabra 
{Nat. Ord. Leguminosae), a small herbaceous perennial plant, of 
the countries around the Mediterranean. It is imported from 
Sicily and Spain; and a portion of the Sicilian root is said to be 

Fig. 44. 




GLYCYRRHIZA GLABRA. 



the product of G. echinata. As found in the shops glycyrrhiza 
is in long wrinkled pieces, often worm-eaten, varying from a few 
lines to more than an inch in thickness, externally grayish-brown, 
internally yellowish, without smell, and of a sweet, mucilaginous* 



DEMULCENTS GLYCYRRHIZINUM. 535 

sometimes slightly acrid taste. The best pieces are of the bright- 
est yellow internally. The powder is grayish-yellow, or, if it be 
powdered with the epidermis removed, pale sulphur-yellow. 
The Russian glycyrrhiza of commerce is said to be derived chiefly 
from G. glandulifera ; the root has a reddish tint and a scurfy 
surface, which distinguish it from the smoother one G. glabra. 
The constituents of glycyrrhiza are a peculiar transparent yellow, 
uncrystallizable sugar, termed glycyrrhizin (C 16 H 24 6 ) (which is 
scarcely soluble in cold water, but soluble in boiling water and 
alcohol, and is a glucoside, splitting up, when warmed with a 
dilute acid or upon being boiled, into glycyrretin and sugar), 
starch, asparagin, an acrid resin, etc. 

Effects and Uses. — A decoction of glycyrrhiza is a useful 
demulcent in dysenteric, catarrhal, and nephritic affections ; it is 
also added to decoctions of acrid substances, to cover their taste 
and acridity. It should be made of the root deprived of its corti- 
cal part, which is acrid and without demulcent virtues ; by long 
boiling the acrid resin is extracted. The powder is used in mak- 
ing pills (see p. 51). A fluid extract \s officinal, and is a useful 
addendum to cough mixtures and to disguise the taste of ammo- 
nium carbonate or chloride. 

Glycyrrhizinum Ammoniatum (Ammoniated Glycyrrhizin) is 
prepared by macerating and then percolating glycyrrhiza with 
water of ammonia, precipitating with sulphuric acid, washing the 
precipitate and dissolving in water of ammonia and spreading on 
glass plates to dry. It may be used for the same purposes as 
the other preparations. 

Extractum Glycyrrhiza {Extract of Glycyrrhiza — Extract of 
Liquorice) is made by the evaporation of a decoction of the half- 
dried root. It comes to this country chiefly from Leghorn and 
Messina, and in part, also, from Spain; a good extract is pre- 
pared, too, in New York and England. The crude extract, when 
good, occurs in black, flattened, cylindrical rolls, about an inch 
in diameter, which are dry, brittle, with a shining fracture, of a 
very sweet, peculiar, slightly acrid taste, and are quite soluble in 
water. It is, however, much sophisticated, and for internal use 
is generally refined by dissolving the impure extract in water and 
water of ammonia, without ebullition, straining the solution and 
evaporating; sugar is often mixed with it, and sometimes muci- 



536 MATERIA MEDICA — TOPICAL MEDICINES. 

lage or glue. Refined liquorice {extractum glycyrrhizce punini) is in 
small cylindrical pieces, not thicker than a pipe-stem. Liquor- 
ice is a pleasant demulcent, much used as an addition to cough 
mixtures and lozenges and to acrid infusions and decoctions. 
Mistier a glycyrrhizce composite/, [compound mixture of liquorice), 
commonly called brown mixture, consists of the pure extract, 
acacia, sugar, each 3 parts; paregoric, 12 parts ; antimonial wine, 
6 parts ; sweet spirit of nitre, 3 parts ; water, 70 parts ; dose, 
foss. Liquorice enters into the composition of several troclies 
already noticed. 

LYCOPODIUM. 

This is the sporules of Lycopodium clavatum or Club-moss,, 
and other species of Lycopodium {Nat. Ord. Lycopodiacese), 
low, creeping perennials, found in dry woods of Europe and 
America. The stem is from 2 to 4 feet long, with numerous 
short ascending branches, having linear awl-shaped leaves ; the 
sporules are found in reniform sporangia of the long peduncle 
which terminates the fertile branches. 

It consists of a fine, yellow, inflammable powder ; odorless, 
tasteless, and not wetted by water, and contains fixed oil and 
volatile bases. 

It is used as a dusting powder, and, as it is not wetted by 
water, makes an excellent application for excoriated surfaces, 
intertrigo, etc. It is particularly useful to prevent the irritation 
caused by the urine or alvine dejections coming in contact with 
the tender or inflamed perinaeum and nates, in infantile cases. 

It is also used in pharmacy to prevent the adhesion of 
pills. 

CETRARIA. 

Cetraria islandica, or Iceland Moss {Nat. Ord. Lichenes), is 
a foliaceous, erect lichen, from two to four inches high, found 
in the northern latitudes and mountainous districts of the new 
and old continents. It is obtained principally from Norway 
and Iceland, but is said to be abundant also in New England. 
As found in the shops it consists of irregularly-lobed and chan- 
nelled coriaceous leaves, fringed at their edges with rigid hairs, 
of a brownish or grayish-white color, darker on the upper sur- 
face, and sometimes marked with blood-red spots. It is almost 
odorless, and has a bitter, mucilaginous taste; its powder is 



DEMULCENTS CETRARIA. 537 

whitish-gray. It gives up its virtues to boiling water, and con- 
sists chiefly of a kind of amylaceous matter (which is colored 
blue by iodine, and is termed lichenin — C 12 H2o0 10 ), and a bitter 
principle termed cetrarin or cetraric acid (C 18 H 16 8 ); it contains, 
besides, other principles. 

Effects and Uses. — Iceland moss is a demulcent tonic, and is 
also highly nutritious. It is adapted to cases requiring a light 

Fig. 45. 




CETRARIA ISLANDICA. 



aliment combined with a mild and acceptable tonic; and from 
its demulcent properties has a soothing influence in inflamma- 
tions of the various mucous membranes. It is chiefly used in 
chronic affections of the pulmonary and digestive organs, in the 
form of decoction {decoctum cetrarice), which may be taken ad 
libitum. By maceration in water or a weak alkaline solution, 
Iceland moss may be deprived of its bitter principle; and it is 
then used as a mild nutritive demulcent. 

CHONDRUS. 

Chondrus crispus, Carrageen or Irish Moss {Nat. Ord. Algae), 
is a marine alga found chiefly on the west coast of Ireland, 
and also on the coast of New England ; it is prepared for use 
by washing, bleaching, and drying. It is also prepared from 



533 



MATERIA MEDICA TOPICAL MEDICINES. 



Chondrus mammilosus. As found in the shops it consists of 
fronds from two to three or four inches long, mostly yellowish 
or dirty-white but intermixed with purplish-red portions, nearly 
inodorous, and of a mucilaginous taste. It swells up in warm 
water, and is almost entirely dissolved when boiled. Its chief 
constituent is a peculiar mucilaginous principle, for which the 
term Carrageenin has been proposed ; and it contains also some 
mucus, resins, etc. 

Effects and Uses. — It is a very agreeable nutritive demulcent, 



Fig. 46. 




CHONDRUS CRISPUS. 



useful in bowel complaints and pectoral affections. It may be 
given in the form of decoction (Sss to water Oiss boiled to Oj) 
flavored with lemon-juice and sugar; or it may be made with 
milk or cream into blanc-mange, which forms an excellent light 
diet for the sick. By saturating two superimposed layers ol 
wadding with a solution of chondrus, and drying them in a stove 
after they have been submitted to strong pressure, a sheet of the 
consistence of cardboard is produced, which, when soaked in hot 
water, makes an excellent poultice. 



AMYLUM STARCH. 

This term is applied by the Pharmacopoeia to the fecula ot 
the seed of Triticum vulgare, the well-known wheat {Nat. Ord. 



DEMULCENTS STARCH. 539 

Graminaceae). It is a proximate principle, however, which per- 
vades the vegetable kingdom, being found in various parts of 
plants, especially in seeds, tubers, and bulbous roots It, is 
obtained by bringing the substances in which it exists to a state 
of minute division, agitating or washing them with cold water, 
straining or pouring off the liquid, and allowing it to stand until 
the fecula which it holds in suspension has subsided. It occurs 
as a white, opaque, odorless, tasteless, powder, or in columnar 
masses of a crystalline aspect, and produces a peculiar sound 
when compressed between the fingers. It is insoluble in alcohol, 
ether, and cold water. Examined under the microscope, starch 
is seen to consist of minute circular or lenticular granules, 
the laminae of which are arranged around a central point or 
hilum, varying in size and shape in the different varieties of 
amylaceous substances. The diameter of the wheat granule 
is about 10 1 00 of an inch. The potato starch granule is the 
largest, that of barley the smallest. The envelope of these 
granules is insoluble in cold water, but is ruptured by heat, so 
that the interior portion is exposed and becomes dissolved; 
hence starch is said to be insoluble in cold, but soluble in boil- 
ing water. Starch is C 6 H 10 (\ and is classed with the carbohy- 
drates. By the action of heat, or by long boiling with diluted 
sulphuric or hydrochloric acid, it is converted into dextrin, an 
isomeric soluble principle, and by the same process this may be 
converted into grape sugar. The same change takes place in 
grains, after germination, through the agency of a nitrogenous 
principle termed diastase. The test for starch is iodine, which 
forms with starch-solution a rich blue iodide; with bromine 
starch strikes an orange precipitate ; nitric acid converts it into 
oxalic acid. 

Effects and Uses. — The starchy or farinaceous articles form an 
important group of nutrients. Their assimilation is effected by 
the albuminous principles of the digestive tube (salivin, pan- 
creatin, etc.), which change starch into grape sugar. This is 
converted in part into fatty tissue, and is partly fermented into 
lactic acid, which acts as a calefacient. Starch is used externally 
as a dusting powder to excoriated surfaces, as an emollient poul- 
tice, and in solution as a vehicle for laudanum as an enema. It 
is the antidote for iodine. 



540 MATERIA MEDICA TOPICAL MEDICINES. 

Glyceritum Amyli (Glycerite of Starch) {Plasma) contains 10 
per cent, of starch thoroughly mixed with glycerin and dissolved 
by the aid of heat. It is excellent as a vehicle for astringent 
applications in ophthalmic surgery, and as an application to allay 
heat, burning and itching of the skin in scarlatina and smallpox ; 
in the latter it is particularly pleasant to the patient, and has as 
much effect in preventing pitting as any other application (H. 
M.). It is used as a substitute for ointments, and is a good 
excipient for pills. Amylum iodatum (iodized starch) has been 
already spoken of (vide p. 431). 

Ichthyocolla (Lsinglass), prepared from the swimming bladder 
of Acipenser Huso (the sturgeon) and of other species " of 
Acipenser (Class, Pisces; Ord. Sturiones) is the purest form of 
gelatin. Court plaster (Emplastrum ichthyocollce) is made by coat- 
ing oiled silk with a solution of isinglass. Gelatin is also used as 
an article of diet, and is employed in pharmacy to make capsules 
for the administration of disagreeable liquid medicines, and as a 
coating for pills. 

For external use, the animal fats are employed as emollients. 
When applied externally, they are absorbed and assimilated, and 
increase the body weight ; hence inunctions have been practiced 
in wasting diseases, as phthisis, etc. They also reduce the tem- 
perature of the body in febrile conditions, and allay itching and 
irritation of the surface, and for this purpose they are employed 
in the exanthemata. They are also used as excipients for other 
medicines, in making ointments, etc. 

Adeps (Lard) is the prepared fat of Sus Scrofa (the hog) ; 
the internal fat of the abdomen is preferred, which is washed, 
melted and strained. Below the temperature of 90 it occurs as 
a soft, white solid, which for medicinal use should be free from 
saline matter. It consists of olein and stearin. It is used in 
pharmacy as an addition to poultices, and as an inunction in the 
exanthemata, particularly scarlatina. Cerate (ceratuni) is made 
by melting together 70 parts of lard and 30 parts of white wax. 
Unguentum (ointment) is made by melting together 80 parts of 
lard and 20 parts of yellow wax. Lard-oil (the olein of lard) is 
a good vehicle for anodyne enemata. 



DEMULCENTS CETACEUM. 54 1 

Adeps benzoinatus (benzoinated lard), formerly termed ben- 
zoinated ointment, consists of benzoin 2 parts in ioo parts of lard. 

Lanolin (unofficinal), the description of which is based on the 
observations of Liebreich,* by whom it was introduced, Lassar,f 
Aubert,J W. G. Smith, || Kinner,§ and what we have observed, is 
the purified fat of sheeps' wool ; chemically, it is a fatty salt of 
cholesterin. It is not a secretion of the sebaceous glands, but a 
retrograde metamorphosis of keratin. It is neutral, of slight 
odor, not readily decomposed, blends easily with glycerin and 
fats, and has considerable capacity for mixing with water. 

Liebreich (loc. cit.) states that corrosive sublimate applied to 
the skin rubbed up with lanolin, soon produces a metallic taste 
in the mouth. Lassar (loc. cit) has shown, too, that cinnabar 
mixed with it penetrates more deeply into the skin than with 
other ointments. Aubert (loc. cit.), on the other hand, affirms that 
he was unable to obtain the constitutional effects of atropine in 
lanolin rubbed on the skin; in fact, he considers it retards, rather 
than accelerates, absorption, so that the matter cannot so far be 
considered as definitely settled. It is an excellent excipient with 
which to apply medicines to the skin ; to assist the removal of 
scales, as in psoriasis ; to Rubricate the cracks and fisures of 
eczema after the acute stage has been passed, and, in fact, wherever 
an unirritating, undecomposable ointment is indicated. It may 
be diluted with other fats and flavored with oil of lavender. 

Sevum (Suet) is the internal fat of the abdomen of Ovis 
Aries (the sheep) (Class, Mammalia; Ord., Ruminantia), puri- 
fied by melting and straining. It is composed almost exclusively 
of stearin, but also contains some palmitin, olein and hircin. 

Cetaceum (Spermaceti) is a peculiar concrete fatty sub- 
stance obtained from Physeter macrocephalus or sperma- 
ceti whale (Class, Mammalia; Ord., Cetacea). It consists 
almost entirely of cetyl palmitate (C 16 H3 3 C 16 H 31 02) or cetin, but 

* Berlin. Klinische Wochen., No. 47, p. 761. f Ibid., No. 5, p. 75. 

% "Congres de Chirurgie" Paris, 1886, quoted. 

|| Brit. Med. Jour., 1886, p. 1106. 

\ Journ. of Cutaneous and Venereal Diseases, 1886, p. 270. 



542 MATERIA MEDICA TOPICAL MEDICINES. 

recently has been shown to contain also ethers of stearic, myristic 
and laurostearic acids ; and of the alcohols, lethal (C^H^O), methal 
(Ci 4 H 30 O), ethal (C 16 H 34 ) and stethal (C 18 H 3i O). Spermaceti cerate 
(ceratum cetacei) is made by melting together 10 parts of sper- 
maceti and 35 parts of white wax, and then adding 55 parts of 
olive oil, previously heated. Ointment of rose-water (see p. 
188) contains spermaceti. 

Cera Flava ( Yellow Wax) is a peculiar concrete substance ' 
prepared by Apis mellifica, the honey bee {Class, Insecta ; Ord. 
Hymenoptera). 

Cera Alba ( White Wax) is yellow wax bleached. They are 
used chiefly in making cerates, ointments and plasters. 

ACIDUM OLEICUM OLEIC ACID. 

Oleic acid (HC 18 H 33 2 ) exists in nature combined with gly- 
cerin as olein. It is obtained in an impure state as a secondary 
product at stearin candle manufactories. To purify the acid, it 
is cooled to 14 F. and expressed; the solid portion melted 
and treated with lead protoxide ; the lead oleate is dissolved 
out by ether, decanted, and shaken with hydrochloric acid, 
which decomposes it ; the ethereal layer is decanted and evapo- 
rated. The oleic acid thus obtained is still contaminated with 
a little oxyoleic acid, which is difficult to separate. Oleic acid 
is a yellowish oily liquid, which becomes brownish and rancid 
by exposure to the air, without smell or taste, soluble in alcohol 
and ether, but insoluble in water. The oleates of the alkaline 
metals are soft soluble soaps ; those of the earthy metals are 
insoluble in water, but soluble in alcohol and ether. 

Oleic acid is used principally in preparing the oleates of vera- 
trine (vide p. 237) and of mercury {vide p. 413). 

OLEUM THEOBROM.E OIL OF THEOBROMA. 

This oil, commonly known as Butter* of Cacao, is the fixed 
oil expressed from the seed of Theobroma Cacao (Nat. Ord. 
Sterculiaceae), a handsome tree, from twelve to twenty feet in 
height, growing in Mexico, the West Indies, Central America 
and South America. The fruit is an ovate-oblong capsule or 
berry, half a foot in length, with a thick, coriaceous, ligneous 



DEMULCENTS GLYCERIN. 543 

rind, inclosing a whitish pulp, in which numerous ovate seeds 
are embedded, about the size of an almond. Separated from 
the matter in which they are enveloped, these constitute the 
chocolate-nuts of commerce (see p. 122). They contain fixed 
oil {cacao butler), theobromine, and other matters. Theobromine 
is a nitrogenous alkaloid, analogous to caffeine. Cacao butter is 
obtained by expression, decoction or the action of a solvent. 
It occurs in whitish or yellowish oblong cakes, of the consist- 
ence of tallow and of an agreeable odor and taste. It con- 
tains a large proportion of stearin, also palmitin and olein. It 
is used in pharmacy for coating pills, and also largely in pre- 
paring suppositories, for which it is well adapted from its 
consistence and blandness. It may be used with advantage as 
an unguent in fevers, to reduce the heat and allay the cutaneous 
irritation. 

GLYCERINUM GLYCERIN. 

This is a substance which exists in oils in combination with 
the fatty acids (stearic, margaric, oleic, etc.), and is liberated 
from them when they unite with bases in the process of saponi- 
fication. It was first obtained in the process for making lead- 
plaster, by mixing litharge (lead monoxide) with olive oil and 
boiling water, by which the fatty acid unites with the lead and 
is precipitated, and the glycerin remains in solution. It is 
freed from any lead it may contain by means of a stream of 
sulphuretted hydrogen gas, and is afterward filtered through 
animal charcoal ; or, as it is now usually made more directly, 
by decomposing fats and distilling by steam under high pres- 
sure. Glycerin (C 3 H 5 3HO), or Glyceric Alcohol, is the hydrate 
of Glyceril, Glycil, or Property I, and is a triatomic alcohol. It is 
a thick, syrupy liquid, colorless or straw-colored, unctuous to 
the touch, inodorous, of a sharp, sweet taste, and of neutral 
reaction. When pure its sp. gr. is 1.260, when it contains 95 
per cent, of absolute glycerin ; the Pharmacopoeia directs its 
sp. gr. to be 1.250. It is soluble in alcohol and water, but is 
insoluble in ether and chloroform, and does not evaporate when 
exposed to the air, but absorbs one-half its weight of water. It 
readily reduces potassium permanganate, with which it is 
incompatible. It has remarkable solvent properties, dissolving 
iodine, bromine, the alkalies, tannic and other vegetable acids, 



544 MATERIA MED1CA TOPICAL MEDICINES. 

a large number of neutral salts, and many organic principles. 
Officinal solutions of medicinal substances in glycerin are termed 
glyccrites (glycerita). 

Effects and Uses. — Glycerin is a bland and unirritating sub- 
stance. It has the capacity of diffusing itself freely over and 
through organic matter, incorporating itself between organic 
molecules, by which it is absorbed and appropriated. It has been 
used internally as a nutrient and demulcent, and has been deemed 
of value in cachectic, strumous and asthenic conditions in children, 
but the weight of opinion is against its efficacy as an alterative. 
It is as a topical application that it is chiefly employed. As an 
enema in dysentery, to soften hardened mucus in the air passages, 
in various cutaneous affections, in diphtheria, in deafness attended 
with dryness of the meatus, and as a vehicle or solvent for active 
medicines, glycerin is a valuable article. Guzzo * recommends the 
following treatment to prevent extensive cicatrization following 
burns : apply to the entire burned surface a piece of lint thickly 
spread with cold cream and covered with a compress two inches 
thick saturated with glycerin (freshly wet from three to six times 
a day ; the whole dressing to be changed daily), and covered with 
a dry compress and bandage. This treatment failed in only one 
of fifty-two cases. f 

Quite recently attention has been called to small rectal injec- 
tions of glycerin (f<5^- j) as a safe, sure, and speedy means of open- 
ing the bowels. It seems to act by irritating the sentient rectal 
nerves, leading to powerful reflex peristalsis, which ends in defe- 
cation (Althaus, \ Anacher § and Mayer \), The liquid may be 
introduced by a rubber urethral syringe. 

Glyceritiim amyli (glycerite of starch) has been already consid- 
ered (vide p. 540). 

Glyceritiim vitelli (glycerite of yolk of eggs) (glyconin) is made 
by mixing thoroughly 45 parts of fresh yolk of egg with 55 parts 
of glycerin. It is a good vehicle for the administration of cod- 
liver oil, a few drops of some aromatic being added as a flavor- 
ing ingredient. 



* Gaillard's Med. J., March, 1882. f Arch. Dermal., Oct., 1882. 

%Brit. Med. J., Dec. 24, 1887, p. 1379. 
I Deals. Med. Wochen., Sept. 15, 1887, p. 823. 
^ Med. Nezvs, Feb. 25, 1888, p. 201. 



DEMULCENTS PYROXYLIN. 545 

PETROLATUM. 

Petrolatum is a mixture of hydrocarbons obtained by distilling 
the lighter and more volatile portion from American petroleum, 
and purifying the remainder. Mineral oils have been known from 
time immemorial, and were obtained by the ancients from Sicily, 
the Ionian Islands and Persia ; later they were found in various 
parts of Europe, Asia and North America, but did not become 
an important article of commerce until 1859, wnen the first oil- 
well was sunk near Titusville, in Pennsylvania. Petrolatum is a 
yellowish, transparent, semi-solid fatty substance, melting at from 
104 to 124 F., insoluble in water and cold alcohol, more so in 
boiling absolute alcohol ; readily soluble in ether, chloroform, oil 
of turpentine, benzin, and the fixed and volatile oils. It consists 
principally of the hydrocarbons of the marsh-gas series. It has 
been introduced into the Pharmacopoeia as a substitute for vase- 
line, cosmoline, and other copyrighted preparations, which consist 
of mixtures of paraffine and the heavier petroleum oils, and, like 
them, possesses the advantage over the animal oils and fats of not 
becoming rancid. 

Effects and Uses. — When taken internally, in large doses, petro- 
leum is said to cause giddiness and oppression, with palpitation 
and headache. It seems to be well borne by the stomach, and 
causes no diarrhcea. It is principally used externally as an unguent 
in scarlet fever and cutaneous affections, and forms an admirable 
basis for other ointments. It is an excellent dressing for wounds. 

PYROXYLI NUM PYROXYLIN. 

Pyroxylin, or Soluble Gun Cotton, is made by adding cotton 
to a mixture of nitric acid gradually added to sulphuric acid, 
and allowing it to macerate ; it is to be washed first with cold 
water, and then with boiling water, and after being drained 
on filtering paper it is dried by means of a water-bath. Pyroxy- 
lin has the appearance of ordinary cotton, but is harsh to the 
touch. It is insoluble in water and alcohol, but, when freshly 
prepared, it dissolves in ether, forming collodion ; it is liable to 
decomposition if kept for some time. 



35 



546 MATERIA MEDICA TOPICAL MEDICINES. 

COLLODIUM COLLODION. 

This is a solution of pyroxylin (4 per cent.) in stronger ether 
(70 per cent.) and stronger alcohol (26 per cent.). Collodion is 
a slightly opalescent, syrupy liquid, with a strong ethereal smell. 
By long standing it deposits a layer of fibrous matter, and be- 
comes more transparent ; this layer should be reincorporated by 
agitation before the collodion is used. When applied to the skin 
the solvent evaporates, and it forms a colorless, transparent, 
flexible and strongly contractile film. In this way it proves anti- 
phlogistic by driving the blood away from a part, limiting effusion 
and promoting absorption, and at the same time acts as an admi- 
rable emollient by protecting an inflamed surface from the action 
of the air. It is a useful application to ulcers, fissures and skin 
diseases, and erysipelatous parts. Marked improvement has fol- 
lowed its daily use in that disfiguring keloid of the face which 
sometimes follows smallpox (H. M.). It is used also in surgery 
as a substitute for adhesive plaster, and in pharmacy as a vehicle 
for other medicines. Iodized collodio?i (a very good solution of 
iodine for external application) contains from ten to twenty 
grains of iodine in a fluidounce of collodion. 

Collodium Flexile {Flexible Collodion) is made by mixing 
92 per cent, of collodion, 5 per cent of Canada turpentine and 3 
per cent, of castor oil. This is a softer, more pliable and more 
elastic preparation, useful in cases where the strongly contractile 
power of ordinary collodion is objectionable. It is a good 
application in eczema. Collodion, in all forms, is to be kept in 
well-stoppered bottles. 

Collodium Stypticum {Styptic Collodion) contains 20 per cent, 
of tannic acid, 5 per cent, of alcohol, 20 per cent, of stronger 
ether and 55 per cent, of collodion. It is an excellent styptic 
application. 

LIQUOR GUTTA-PERCHA SOLUTION OF GUTTA-PERCHA. 

This is a solution of 9 per cent, of gutta-percha in 91 per cent, 
of commercial chloroform. In preparing it lead carbonate is 
employed to free it from coloring matter. It is a clear, colorless 
or nearly colorless solution, and should be kept in well-stoppered 
glass vials. By the evaporation of the chloroform, this proves 
an admirable application to inflamed or abraded parts, in skin 



DEMULCENTS SUGAR. 547 

affections, chaps, etc.; it is also an excellent protective coating 
to parts threatened with bed-sores or liable to excoriations, and 
for the retention of medicinal substances upon the skin, in dermal 
therapeutics, as chrysarobin (q. v.) to ringworm. 

LIQUOR SODII SILICATIS SOLUTION OF SODIUM SILICATE. 

This solution (commonly known as Solution of Soluble Glass) 
is made by fusing together fine sand and dried sodium carbonate, 
and dissolving the product in hot water. It is a semi-transparent, 
colorless, viscid liquid, without smell but having a sharp, alkaline 
taste, which, on drying, becomes a transparent glass-like mass. 
It has been used as a local application in erysipelas, but is chiefly 
used in making permanent dressings in the treatment of fracture. 
For this purpose it should be thoroughly applied on successive 
layers of the dressing to the part and allowed to harden. 

SACCHARUM SUGAR. 

Sugar is a principle diffused through the vegetable world 
under many forms, all distinguished by a sweet taste. They are 
divided into two chief groups — Cane Sugar and Grape Sugar. 
Cane-sugar is the product of Saccharum officinarum {Nat. Ord. 
Graminaceae), a native of tropical countries, cultivated most suc- 
cessfully in the West Indies, and to some extent in Louisiana. 
It has a general resemblance to Indian corn. The juice of the 
sugar-cane is extracted by crushing and expressing the stalks ; 
it is then boiled with quicklime, strained, and reduced by evapo- 
ration to a thick syrup, which is cooled and granulated in shal- 
low vessels. Raw sugar is refined by the agency of animal 
charcoal. Cane-sugar is made also in France from the beet-root. 
When pure, cane-sugar is white, crystallized in translucent, 
double oblique prisms, very sweet, soluble in one-third its weight 
of water, in alcohol, but not in ether. At a heat of 220 F. it 
melts and cools into a glassy, amorphous mass, known as barley- 
sugar ; from a strong solution it can be made to crystallize 
slowly upon a string as rock-candy. 

The uncrystallizable portion, which is drawn off in the granu- 
lation of sugar, is molasses or treacle, a dark, brownish-black ) 
syrupy liquid. 

Grape-sugar is the sugar of grapes and other acid fruits ; it 



54-8 MATERIA MEDICA TOPICAL MEDICINES. 

is also found in the liver and blood of mammalia, and in the 
urine of diabetes mellitus. It may be procured artificially by 
acting on starch with diluted sulphuric acid. It occurs as 
whitish or grayish-white, non-crystalline masses, or as a dense 
transparent syrup. 

Cane-sugar (C 12 H 2 20 U ) combines with alkalies to form saccha- 
rates. Grape-sugar (C 6 H ]2 6 .H 2 0), when boiled with an alkali, 
is transformed into the acid of molasses, melassic acid ; mixed 
with solution of potassa and a weak solution of cupric sulphate, 
it attracts oxygen, and causes the precipitation of a reddish, 
cuprous oxide (Cu 2 0). 

Effects and Uses. — Sugar, especially in the form of barley- 
sugar, is an excellent demulcent to relieve catarrhal irrita- 
tion ; much of the cough-relieving action of cough-syrups is 
due to the sugar they contain. It abates thirst, and is used 
to flavor refrigerant drinks. For pharmaceutical purposes sugar 
is much employed, for its agreeable taste, and also as a pre- 
servative of vegetable substances, and to protect mineral medi- 
cines from oxidation. Molasses is slightly laxative as well as 
demulcent. 

Mel {Honey). This saccharine liquid, the familiar product of 
the bee (Apis mellifica), best used in the form of mel despu- 
matum {clarified honey) y is a slightly laxative article of food, and 
is used in pharmacy, and as an agreeable demulcent ingredient 
in gargles. 

Saccharum Lactis {Sugar of Milk) (C^f^On-H^O), the 
saccharine principal of milk, obtained from whey, is used as a 
bland non-nitrogenous article of diet. It is used in preparing 
abstracts and to insure the admixture of powders, as in pulvis 
ipecacuanhce et opii. 

SACCHARIN* (UNOFFICINAL). 

This, a recently introduced therapeutic agent, is a product of 
the coal-tar derivatives, being derived from the aromatic group 
of hydrocarbons, and is chemically anhydro-orthosulphamin- 

* Brit. Med. Journ., Oct. 15th, 1887. 



DEMULCENTS CHARCOAL. 549 

benzoic acid (Fahlberg*). It is a white, crystalline powder, un- 
alterable at ordinary temperatures, of an acid reaction, slightly 
soluble in cold water, dissolves in alcohol, glycerin and ether, 
and unites with the alkalies to form definite salts. Its most 
characteristic property is sweetness, saccharin being in this re- 
spect about 300 times greater than that of cane-sugar. 

Effects and Uses. — When taken internally, even in large quan- 
tity (5ss-gr. lxxx), it is innocuous. Dogs fed on it together with 
their ordinary diet, according to Egasse,f did not increase in 
weight, nor was any alteration either in the quantity, specific 
gravity, or proportion of urea in their urine, found. It passes 
through the economy undecomposed, since it can be detected in 
the urine unchanged, but it has not been discovered in the saliva 
or feces. In its exit by the kidneys it exerts a decided influence 
in restraining the alkaline fermentation of the urine. 

It is chiefly employed as a substitute for sugar in obesity, and 
in diabetes mellitus, gr. j-ij being sufficient to sweeten the tea, 
coffee, sugar or food; and as a corrective of the taste of certain 
bitter medicines, as quinine (q. v.). 

CARBO LIGNI CHARCOAL. 

Although not strictly ranking with demulcents, the medicinal 
uses of charcoal may, perhaps, be appropriately noticed under 
this head. Charcoal is prepared by the exposure of wood to a 
red heat without access of air. For medicinal purposes the 
charcoal prepared from young willow-shoots for the manu- 
facture of gunpowder is preferred. It is a black, shining, 
brittle, porous substance, without odor or taste, and insoluble 
in water. 

Effects and Uses. — It is employed internally as an absorbent of 
acrid secretions, in dyspepsia (in which it is often very useful), 
in gastric irritation, diarrhoea and dysentery ; dose, from one to 
four teaspoonfuls. Externally it is used with effect to absorb the 
offensive gases given off from foul sores, in the form of poultice, 
mixed with flaxseed meal, or with bread-crumb, which is 



* Amer. Chem. Journ., 1879; Vol. I, p. 436. 

f Bull. Gen. de Therap., Oct. 30th, 1888, p. 337 ; an elaborate article. 



550 MATERIA MEDICA TOPICAL MEDICINES. 

better from its porosity ; dry charcoal is sprinkled with advan- 
tage over sloughing ulcers, and appears to promote the separation 
of the sloughs. 

ORDER IV. COLORING AGENTS. 

These are employed exclusively for pharmaceutical pur- 
poses. The following articles enter into officinal preparations, 
to which they are intended to communicate their peculiar 
color : — 

CROCUS SAFFRON. 

This is the stigmas of Crocus sativus [Nat. Ord. Iridacese), 
a small perennial plant, a native of Greece and Asia Minor, but 
now cultivated all over Europe and in our own country. In 
Lancaster county, Pennsylvania, it has been raised to consider- 
able extent. The stigmas are an inch or more in length, of a 
rich deep orange color, a peculiar aromatic odor and a warm» 
pungent, bitter taste ; they contain a principle termed saffranin 
or polychroit (C 48 H 60 O 18 ). 

Saffron is now admitted to possess little, if any, medicinal 
activity, and is used only to impart color and flavor to officinal 
preparations. The tincture contains 10 per cent, of saffron. 

SANTALUM RUBRUM RED SAUNDERS. 

This is the wood of Pterocarpus santalinus, a large tree of 
India and Ceylon (Nat. Ord. Leguminosae). It comes in round- 
ish or angular billets, internally of a blood-red color, externally 
brown, of little smell or taste ; in the shops it is found in the 
form of chips, raspings or coarse powder. It contains a resinoid 
matter, santal (C 8 H 6 3 ), pterocarpin (C 17 H 16 5 ) and santalic acid. 
It is employed solely to give color to spirits and tinctures. 

COCCUS COCHINEAL. 

This is an insect, termed Coccus cacti (Class, Insecta; Ord. 
Hemiptera), of Mexico and Central America, naturalized in 
Teneriffe and other places. The female insect, dried, consti- 
tutes the article of the shops. It occurs in the form of 
roundish or somewhat angular grains, about an eighth of an 
inch in diameter, convex on one side, concave or flat on the 
other, and wrinkled. Two varieties are distinguished, one 



ANTHELMINTICS SPIGELIA. 55 I 

reddish-gray, the other nearly black, known as silver grains 
and black grains. It has a faint, heavy odor and a bitter, 
slightly acidulous taste ; its coloring principle is carminic "acid 
(C 17 H 18 O 10 ). 

Cochineal has had antispasmodic virtues attributed to 
it, and has been used in whooping-cough, especially in 
combination with potassium carbonate; dose, to infants, gr. 
*/} t. d. It is employed chiefly, however, to color tinctures and 
ointments. 

ORDER V. ANTHELMINTICS. 

Anthelmintics are medicines which promote the destruc- 
tion and expulsion of worms from the alimentary canal. 
When a medicine simply causes the expulsion of the parasite 
it is called a vermifuge ; when it causes the death of the 
worm, a vermicide. They act in different ways ; some weaken 
or destroy the worms by a direct poisonous influence, others 
by mechanical means. The drastic cathartics have an anthel- 
mintic effect from the increased secretion and exhalation which 
they induce from the alimentary canal. 

SPIGELIA. 

Spigelia, called also Pinkroot, is the rhizome and rootlets 
of Spigelia marilandica, or Carolina Pink {Nat. Ord. Logan- 
iaceae), an herbaceous indigenous plant, found chiefly in our 
southern and southwestern States. The rhizome is horizontal, 
thick, bent, purplish-brown, branched on upper side with cup- 
shaped stars, on the low r er numerous thin, brittle, light-colored 
rootlets. It must not be confounded with the under-ground por- 
tion of the Phlox Carolina, also called Carolina pink. The stems 
are numerous, from a foot to a foot and a half high, of a purplish 
color, furnished with sessile, opposite, ovate-lanceolate leaves, 
and terminate in spikes, bearing funnel-shaped flowers, of a rich 
carmine color externally and orange-yellow within, which appear 
from May to July. The rhizome and rootlets, as found in 
the shops, consist of numerous slender, wrinkled, branching, 
brownish fibres attached to a dark-brown caudex, and have a 
faint, peculiar smell and a sweetish, slightly bitter taste; their 
activity is diminished by time. Boiling water extracts its virtues, 



552 



MATERIA MEDICA TOPICAL MEDICINES. 



which are thought to depend upon a bitter principle ; it contains 
also volatile oil, resin, a little tamiic acid, etc. 

Effects and Uses. — In ordinary doses spigelia often proves 
anthelmintic without any sensible effect on the system. In 



Fig. 47. 




SPIGELIA MARILANDICA. 



larger doses it purges and sometimes vomits; and in excessive 
doses it operates as a narcotic, producing vertigo, dilated pupils, 
flushing of the face, etc. The following results were obtained by 



ANTHELMINTICS CHENOPODIUM. 553 

Hare* with spigelia on dogs. Three ounces of the fluid extract 
caused constant retching, pupillary dilatation, internal strabismus, 
rapid respiration, progressive muscular palsy, coma and death. 
Injected into the veins it slowed the heart's action, the retarda- 
tion being chiefly due to central inhibitory stimulation. As 
death approaches, its depressing action on the respiratory centre 
is marked. It is less apt to occasion narcotic effects when it 
acts on the bowels, and hence it is usually combined with or 
followed by cathartics. As an anthelmintic against lumbrici (or 
round worms) it is considered the most reliable article we 
possess. 

Administration. — Dose of the powdered root, 5j-ij for *an 
adult; for a child three or four years old, gr. x-xx, to be 
repeated night and morning for three or four days, and fol- 
lowed by a brisk cathartic; calomel is sometimes combined 
with it. The fluid extract may be given in the dose of f5j or 
more; to a child two years old, ten drops may be given. 
Under the name of worm-tea, preparations containing spigelia 
and cathartics are kept in the shops, as in the following 
formula : spigelia, §ss ; manna, o) ; senna and fennel, each 5ij ; 
savine, gr. xl; to be infused in Oj of boiling water, and f§ss 
given to a child two years old, t. d. 

CHENOPODIUM. 

Chenopodium, or American Wormseed, is the fruit of Che- 
nopodium ambrosioides, or Jerusalem Oak {Nat. Ord. Chenopo- 
diaceae), an indigenous, herbaceous, perennial plant (found most 
abundantly in the southern States), from two to five feet high, 
with alternate oblong-lanceolate, sinuated and toothed yellowish- 
green leaves, with numerous small flowers of the same color 
arranged in long terminal panicles. Chenopodium, as found in 
the shops, is in small spherical grains, not larger than a pin's 
head, of a dull greenish-yellow or brownish color, a peculiar 
offensive smell, and a rather aromatic, pungent taste. Their 
sensible and medicinal properties are owing to a volatile oil 
(Oleum Chenopodii), obtained by distillation. 

Effects and Uses. — Chenopodium is a very efficient anthelmintic, 

*Med. A r ews, March 12, 1887. 



554 



MATERIA MEDICA TOPICAL MEDICINES. 



particularly adapted to the expulsion of lumbrici from children. 
Dose, gr. xx-xl for a child two or three years old, in molasses, 
night and morning, for three or four days, to be followed by a 



Fig. 48. 




CHENOPODIUM AMBROSIOIDES. 



brisk cathartic. The oil is more used than the fruit ; dose, gtt. 
v-x for a child, in emulsion with sugar. The expressed juice of 
the leaves and a decoction made with milk are also used. 



' SANTONICA. 

The unexpanded flower-heads of Artemisia maritima {Nat. 
Ord. Compositse), a native of Persia, and of other species of arte- 
misia, are used as an anthelmintic (in the dose of gr. x-xxx), under 
the name of Levant Wormseed. They resemble small seed in 



ANTHELMINTICS SANTONICA. 555 

appearance, are about a line in length, oval, obtuse at both ends, 
of a greenish-brown color, a strong, somewhat terebinthinate 
odor, and a bitter, camphoraceous taste. They contain volatile 
oil, resin, and a peculiar principle termed santonin, which is pre- 
pared by digesting santonica and lime in diluted alcohol, adding 
acetic acid, crystallizing, boiling with alcohol, digesting the tinc- 
ture with animal charcoal, filtering and crystallizing. 

Santoninum {Santonin) is a neutral principle (C 15 H 18 3 ), and 
occurs in colorless, shining, flattened prisms, without smell, nearly 
tasteless at first, but after a time bitter ; it becomes yellow on 
exposure to the light. It is nearly insoluble in cold water, solu- 
ble in 250 parts of boiling water, in 40 parts of cold and 3 parts 
of boiling alcohol, and in 160 parts of ether, and is readily solu- 
ble in chloroform. This is the anthelmintic constituent of san- 
tonica, and is a most efficient anthelmintic for lumbrici ; but in 
large doses it is capable of producing serious if not fatal poison- 
ing,* gr. vj having killed a child aged 5 years thirty-five minutes 
after ingestion. Krauss f experimentally ascertained that it was 
absorbed by the blood, where it exists for a time undecomposed ; 
he states, too, that it affects the central nervous system, in small 
doses as a narcotic, in large as a tetanizer, the symptoms being 
(occasionally but not invariably) vomiting, giddiness, ocular 
scintillations, incoherence of ideas, stupor, coldness of the skin, 
with clammy perspiration, and, finally, tetanic convulsions. A 
remarkable effect of santonin, even in moderate amounts, is a 
change in the field of vision, so that objects are seen as if through 
a yellow medium. When allowed to remain in the system, san- 
tonin is supposed to be converted into a substance termed xan- 
thopsin, which is eliminated through the kidneys, producing a 
yellow discoloration of the urine ; and probably it is this trans- 
formation which gives rise to the poisonous symptoms occasion- 
ally noticed.^ Hence, santonin is best administered with calo- 



* " St. Thomas' Hosp. Reports," Vol. x. 

f Inaug. Diss., Tubingen, 1869., Ueb. d. Wirk. d. Santonins, etc. 

% Some persons would seem to be peculiarly susceptible to the action of this 
drug, as the editor has seen all the poisonous effects above described, except the 
convulsions, produced in a woman 35 years of age, to whom he had administered 
two doses of gr. ^ of Santonin with gr. j of Calomel, at an interval of 2 hours 
(H. M.). 



55^ MATERIA MEDICA TOPICAL MEDICINES. 

mel or other purgatives. W. G. Smith* detected santonin in his 
own urine, but could not find it in the saliva. Dose, gr. ss-v two 
or three times a day, in the form of syrup, or in pill. 

Sodii Santoninas {Sodium Santoninate) (2NaCi5H 19 4 .7H 2 0) is 
made by adding santonin, as long as it is dissolved, to a hot solu- 
tion of caustic soda and allowing the liquid to evaporate slowly. 
It is rapidly absorbed after ingestion, appearing in the urine in 
half an hour. It produces effects similar to those of santonin, but 
of a milder grade (Krauss, loc. cit.). 

Trochisci Sodii Santoninatis (Troches of Sodium Santoninate) ; 
each troche contains gr. j of sodium santoninate, with sugar, 
tragacanth, and orange-flower water. 

azedarach. 
This is the bark of the root of Melia Azedarach, or Pride of 
China {Nat. Ord. Meliaceae), an Asiatic tree, cultivated exten- 
sively as an ornamental tree in our southern States. It has a 
bitter, nauseous taste, and yields its virtues to boiling water. Its 
effects are said to resemble those of spigelia. The decoction is 
the preferred form of administration (giv to water Oij, boiled to 
Oj) ; dose for a child, fSss every two or three hours, till it affects 
the stomach and bowels ; or night and morning for several days. 

ASPIDIUM. 

Aspidium filix-mas, or Male Fern, and A. marginale (Nat. 
Ord. Filices) are plants found in both hemispheres, from Green- 
land to Natal, and from Japan to Peru, though not indigenous 
in the eastern United States. They have a perennial horizontal 
root, from which spring numerous annual oval, lanceolate, acute, 
bright-green pinnate fronds or leaves, from a foot to four feet in 
height, grouped together in the form of a base ; the leaflets are 
deeply lobate, oval, crenate at their edges, and gradually diminish 
from the base of the pinna to the apex. The rhizome is the 
portion used. It is a long, cylindrical caudex, covered with por- 
tions of the stipes, and as found in the shops it is generally broken 
into fragments, of a brown color externally, internally yellow- 
ish-white or greenish, with a peculiar feeble odor and a sweetish, 

* Dublin Quart. Journ. of Med. Set., 1 870, p. 296. 



ANTHELMINTICS POMEGRANATE. 557 

bitter, astringent, nauseous taste. It deteriorates by keeping. It 
contains jilicic acid (Ci 4 H 18 5 ), on which its medicinal properties 
are said to depend ; also volatile oil, fixed oil, resin, tannic and gal- 
lic acids, etc. ; ether is the best solvent to extract its virtues. 
Besides the above, Daccomo * has recently isolated a waxy sub- 
stance (Ci 3 H 26 0), Aspidol (C20H34O), and two resins. He failed 
to find the essential oil obtained by Schoonbroodt.f 

Effects and Uses. — Aspidium possesses tonic and astringent 
properties ; but its chief use is to cause the expulsion of taenia, 
which it destroys by a specific action. J. Harley % states that it 
does not kill the entozoon, but simply detaches it from the intes- 
tinal wall, and causes its evacuation by the force of the peristaltic 
contractions induced by its action. Its efficacy in this respect 
has been long and well attested, but it is most used to destroy 
the Swiss variety of taenia (bothriocephalus latus). Recently a 
fatal case of poisoning § by aspidium has been reported, with 
symptoms of choleraic diarrhoea. The patient was given 5j }4, of 
an ethereal extract by mistake. The post-mortem appearances 
were intense congestion of the stomach, with ecchymoses beneath 
the mucous membrane and blood-clots on the mucous surface. 
Dose, of the powder, 5j-iij, in electuary or emulsion, night and 
morning for one or two days. The oleo-resin {oleoresina aspidii) 
is the best preparation ; it is a dark, thick liquid, of a bitterish, 
nauseous, slighly acrid taste ; dose, f 5ss-j night and morning for 
a day or two, to be followed by a cathartic. The administration 
of the taeniacide agents should always be preceded by a twenty- 
four hours' fast. 

GRANATUM POMEGRANATE. 

The bark of the root of Punica Granatum is used for the 
expulsion of taenia. It contains pelletierine (C 8 H ]5 NO), which, 
according to the later researches of its discoverer, M. Tanret, || 
is a compound body, consisting of several alkaloidal principles. 
In large doses it is said to cause paralysis of the motor nerves, 
without affecting sensation, and to cause dilatation of the capil- 



*" Annali di Chimica," Agosto, 1887, p. 69. An elaborate investigation. 
f Jour, de Med. de Chir. et de Pharm., Bruxelles, 1868, p. 64. 
X" Royle's Materia Med.," p. 370. \ Lancet, Oct., 1882, p. 630. 

\Bull. Gen. de Therap., XCVin, p. 316. 



558 MATERIA MEDICA TOPICAL MEDICINES. 

laries. It is an active taeniacide, but is apt to cause nausea and 
sometimes vomiting. Pelletierine tannate may be given in doses 
of gr. v-xv on an empty stomach, and is best preceded by a pur- 
gative. If the drug do not move the bowels, a brisk cathartic 
should follow its administration. Berenger-Feraud * recently 



Fig. 49. 




PUNICA GRANATUM. 



observes that the exhibition of a drastic, as jalap, or scammony, 
with pelletierine, decidedly aids this agent in the expulsion of 
taenia. 

Besides its tceniacide action, granatum is a powerful styptic. It 
is given in decoction (§ij to water Oij, boiled to Oj); dose, f 5ij or 
more. 

Oleum Terebinthin^e {Oil of Turpentine) (see p. 384) is used 
as a remedy for taenia and other worms. Dose, fSj, combined 
with or followed by castor oil. 

Calomel (see p. 414) is a valuable anthelmintic, given in 
cathartic doses. 

Brayera {Koosso). The female inflorescence of Brayera 
anthelmintica (Nat. Ord. Rosaceae), a native of Abyssinia, have 
been introduced into European practice as a remedy for taenia, 
under the name of Koosso, They occur in broken, compressed 
clusters, of a greenish-yellow color, a fragrant balsamic odor, 
and a faint taste which after a time becomes acrid and disagree- 
able. They are said to impart their virtues best to hot water, 
and to yield gum, resin, fatty matter, tannic acid, and about three 
per cent, of a peculiar principle termed kosin, a yellow-white 
crystalline resin, without smell or taste, to which its anthelmintic 



Bull. Gen. de Therap., Aout. i5*ieme ) p. 120, i< 



ANTHELMINTICS PUMPKIN-SEED. 559 

properties are attributed (Bedell *). They are given best upon 
an empty stomach, after a previous evacuation of the bowels, 
in infusion (6 parts of the powder with ioo parts of boiling 
water). 

Extr actum Brayerce Fluidum [Fluid Extract of Br ay era) ; dose, 
f5ij-iv. 

KAMALA. 

This is the glands and hairs obtained from the capsules of 
Mallotus philippinensis {Nat. Ord. Euphorbiaceae), a small tree 
of Hindostan and the East India islands. It is an orange-red, 
granular, inflammable powder, with little smell or taste, insol- 
uble in cold and nearly so in boiling water, forming, with alco- 
hol, ether or chloroform, red solutions, due to the extraction of 
the resin. It consists chiefly of resinous substances, to one of 
which, soluble in ether, and considered the active constituent, 
the name of rottlerin (C 2 2H2o0 6 ) has been given. 

Uses. — Kamala (formerly called Rottlerd) is a highly-esteemed 
tceniacide in India, and has been introduced into Europe and 
our own . country. Dose of the powder, 5j-ij, suspended in 
syrup. A tincture (Syj to alcohol Oj) is given in the dose of 
f 3j-iv. Castor oil should be taken after the medicine. 

PEPO PUMPKIN-SEED. 

The seed of Cucurbita Pepo, or common Pumpkin (Nat. 
Ord. Cucurbitaceae), is probably the most efficacious remedy 

Fig. 50. 




CUCURBITA PEPO. 

A. Divided. B. Entire. 



known in the expulsion of tape-worm. These seeds are oval, 
flattish, grooved, 9 lines long by 5 or 6 in breadth, of a light 

*" Biennial Retrosp., etc., New Syd. Soc.," 1867-8, p. 475. 



560 MATERIA MEDIC A TOPICAL MEDICINES. 

brownish-white color, a sweetish, oily taste, and aromatic smell. 
They owe their activity to a principle soluble in ether, chloro- 
form, and especially alcohol. Dose, §j— ij of the fresh seeds, de- 
prived of their outer envelope, beaten to a paste with finely- 
powdered sugar, and diluted with water or milk, may be taken 
after a twenty-four hours' fast, and followed in two or three 
hours by a dose of castor oil. A fluid extract, made with alco- 
hol and glycerin, is probably the best preparation; dose, f §ss-j. 



APPENDIX 



SIGNS AND ABBREVIATIONS USED IN PRESCRIPTIONS. 

R , Recipe, take. 
aa, Ana (ava), of each, 
lb, Libra, librce, a pound, pounds. 
5j , Uncia, uncice, an ounce, ounces. 
g , Drachma, drachmce, a drachm, drachms. 
^ , Scrupulus, scrupuli, a scruple, scruples. 
O, Octarius, octarii, a pint, pints, 
f^ , Fluiduncia, fluiduncice, a fluidounce, fluidounces. 
f 3 , Fluidrachma, fluidrachmcz, a fluidrachm, fluidrachms. 
TTL, Minimum, minima, a minim, minims. 

Ad 2 Vic, v^ dW.? z/zV&r, at two takings. 

Ad Lib., Ad libitum, at pleasure. 

Add., Adde, addantur, add, let be added. 

Altern. Horis, Alternis horis, every other hour. 

Aq. Destil., Aqua destillata, distilled water. 

Aq. Ferv., Aqua fervens, hot water. 

Aq. Fluvial., Aquafluvialis, river water. 

Aq. Font., Aqua fontana, spring water. 

Aq. Pluv., Aqua pluvialis, rain water. 

Bis Ind., Bis indies, twice a day. 

Bull., Bulliat, bulliant, let it or them boil. 

Cap., Capiat capiendum, let the patient take it ; it must be taken. 

Chart., Chartula, chartulce, a small paper, or papers. 

COCHLEAT., Cochleatim, by spoonfuls. 

Coch. MAG., Cochleare magnum, a tablespoonful. 

Coch. Med., Cochleare medium, a dessertspoonful. 

COCH. Parv., Cochleare parvum, a teaspoonful. 

Col., Cola, coletur, strain, let it be strained. 

Collyr., Collyrium, an eye- water. 

Comp., Compositus, compounded. 

Cong., Congius, Congii, a gallon, gallons. 

C. M. S., Cras mane sumendus, to be taken to-morrow morning. 

C. N., Cras node, to-morrow night. 

Decoc, Decoctum, a decoction. 

De D. in D., De die in diem, from day to day. 

Dieb. Alter. , Diebus Alternis, every other day. 

DiL., Dilue, dilutus, dilute, diluted. 

Dim., Dimidius, one-half. 

Div., Divide, divide. 

D., Dosis, a dose. 

Elec., Electuarium, an electuary. 

Enem., Enema, enemata, a clyster, clysters. 

Exhib., Exhibeatur, let it be administered. 

F. H., Fiat haustus, let a draught be made. 

Fil., Filtra, filter. 

36 561 



562 APPENDIX. 

Ft., Fiat, Ji ant, let there be made. 

Garg., Gargarysma, a gargle. 

Gr., Gramwi, grana, a grain, grains. 

Gtt., Gutta, guttcE, a drop, drops. 

Guttat., Gtittatim, by drops. 

Haust., Hanstus, 2l draught. 

Ind., Indies, daily. 

Inf., Infunde, pour in. 

Infus., Infustim, an infusion. 

Inj., Injiciatur, let it be injected. 

Jul., Julepus, julepum, a julep. 

M., Misce, mix. 

Mane, in the morning. 

Mist., Mistura, a mixture. 

Mic. Pan., Mica panis, crumb of bread. 

No., Nui7iero, in number. 

Omn. Hor., Omni hora, every hour. 

Omn. Bid., 0??ini bidtw, every two days. 

Omn. Bih., Omni bihora, every two hours. 

Omn. Man., Omni mane, every morning. 

Omn. Nocte, Omni node, every night. 

Omn. Quadr. Hor., Omni quadrante horce, every quarter of an hour. 

Ph., Pharmacopoeia. 

Pocul., Poculum, a cup. 

P. R. N., Pro re nata, as the symptoms may call for. 

Pl?lv., Pulvis, a powder. 

Q. P., Quantum placeat, as much as you please. 

Q. S., Quantum sufficit, enough. 

Quor., Quorum, of which. 

Redig. in Pulv., Redigatur in pulverem, let it be reduced to powder. 

Repet., Repetattir, repetantur, let it or them be repeated. 

S., Signa, write. 

S. A., Secundum art em, according to art. 

Semih., Semihora, half an hour. 

Sign., Signatura, a label. 

Ss., Semis, a half, 

Sum., Sume, sumendus, let it be taken. 

Tabel., Tabella, a lozenge. 

Troch., Trochiscus, a lozenge. 

Trit., Trittira, triturate. 



INDEX 



Abbreviations, table of, 561 
Abies balsamea, 382 

canadensis, 51 1 

excel sa, 510 

picea, 510 
Abscesses ; application of remedies to, 
Absinthe, 140 
Absinthin, 1 40 
Absnthium, 140 
Absinthol, 140 
Abstract of aconite, 232 

belladonna, 93 

conium, 280 

digitalis, 273 

hyoscyamus, 97 

ignalia, 257 

jalap, 344 

nux vomica, 257 

podophyllum, 347 

senega, 380 

valerian, 120 
Abstracta, 50 
Abstracts, 50 
Abstractum aconiti, 232 

belladonna, 93 

conii, 280 

digitalis, 273 

hyo?cyami, 97 

ignatise, 257 

jalapse, 344 

nucis vomicae, 257 

podophylli, 347 

senegae, 380 

Valerianae, 120 
Acacia, 528 

Catechu, 182 

Verek, 528 
Aceta, 56 
Acetanilide, 482 
Acetaphone, 87 
Acetate of ammonium, solution of, 247 

copper, 196 

iron, solution of, 166 
tincture of, 166 

lead, 192 

morphine, 83 

potassium, 366 

sodium, 366 

zinc, 197 
Acetic acid, 249, 353 



69 



Acetic acid, diluted, 249 
glacial, 249 

extracts, 57 
Acetophenone, 87 
Acetum lobeliae, 296 

opii, 83 

sanguinariae, 315 

scillae, 369 
Acid, acetic, 249, 353 

aconitic, 227 

anemonic, 237 

angelic, 310 

anthemic, 138 

arabic, 529 

aromatic sulphuric, 170 

arsenious, 439, 521 

artanthic, 392 

benzoic, 397, 398, 475, 485 

boheic, 121 

boracic, 471 

boric, 471 

butyric, 353 

cafteic, 121 

caffeo tannic, 121 

cambogic, 351 

camphoric, 117 

camphoronic, 117 

cantharidic, 514 

carbolic, 474, 476 

carbonic, 528 

carminic, 551 

catechu-tannic, 183 

cathartic, 340 

cetraric, 537 

chelidoninic, 348 

chromic, 520 

chrysophanic, 336, 524 

cincho-tannic, 143 

cinnamic, 217, 397, 398 

citric, 249, 250 

cocatannic, 122 

columbic, 134 

copaivic, 388 

cornic, 153 

cubebic, 390 

cyanhydric, 296 

diluted acetic, 249 

hydrobromic, 291 
hydrochloric, 172 
hydrocyanic, 296 



563 



564 



INDEX. 



Acid, diluted muriatic, 172 

nitric, 171 

nitro-hydrochloric, 173 

nitre-muriatic, 173 

phosphoric, 174 

sulphuric, 170 
ergotinic, 262 
eruic, 508 
eugenic, 218 
euonic, 349 
ferulaic, 113 
filicic, 557 
formic, 283 
gallic, 180, 186 
gelseminic, 305 
gentisic, 133 
glacial acetic, 249 
guaiacic, 362 
guaiaconic, 362 
guaiaretic, 362 
gummic, 529 
hippuric, 486 
bydrobromic, diluted, 291 
hydrochloric, 172 
hydrocyanic, 296, 299 
igasuric, 252 
ipecacuanhic, 313 
juglandic, 337 
kinic, 143 
kino-tannic, 183 
kinovic, 143 
kramero tannic, 184 
lactic, 174 
lobelic, 294 
margaric, 543 
meconic, 74, 76 

mercurial nitrate, 410, 423, 522 
meta-benzoic, 475 
mimo-tannic, 179 
muriatic, 172 

nitrate of mercury, 410, 423, 522 
nitric, 171 

nitro-hydrochloric, 1 73 
nitro-muriatic, 173 
oenanthic, 210 
oleic, 542, 543 
ophelic, 136 
ortho-benzoic, 475 
para-benzoic, 47,5 
phenic, 476 
phosphoric, 174 
podophyllinic, 346 
polygalic, 379, 380 
polygonic, 402 
potassium tartrate, 334, 366 

sulphate, 508 
prussic, 296 
pyroligneous, 385, 480 
querci-tannic, 185 
quillaiac, 380 
quinine sulphate, 150 



Acid, rheo-tannic, 336 
rheumic, 336 
ricinic, 324 

salicylic, 322, 475, 489 
santalic, 550 
sclerotic, 261, 266 
sphacelinic, 262 
stearic, 543 
succinic, 130, 348 
sulphuric, 169 
sulphurous, 470 
tannic, 178, 179, 185, 187 
tartaric, 250 
thebolactic, 74 
tiglinic, 353 
toxicodendric, 259 
tropic, 93 

valerianic, 119, 308, 310, 353 
Acida mineralia, 169, 523 

vegetabilia, 248 
Acids, mineral, 169, 523 

vegetable, 248 
Acidum aceticum, 249 

dilutum, 249 

glaciale, 249 
arseniosum, 439, 521 
benzoicum, 485 
boricum, 471 
carbolicum, 476 

crudum, 476 
chromicum, 520 
citricum, 250 
gallicum, 180 

hydrobromicum dilutum, 291 
hydrochloricum, 172 

dilutum, 172 
hydrocyanicum dilutum, 296 
lacticum, 174 
nitricum, 171 

dilutum, 171 
nitro-hydrochloricum, 173 

dilutum, 173 
oleicum, 542 
phosphoricum, 173 

dilutum, 174 
salicylicum, 489 
sulphuricum, 169 

aromaticum, 170 

dilutum, 170 
sulphurosum, 470 
tannicum, 179 
tartaricum, 250 
Acipenser Huso, 540 
Aconine, 227 
Aconite, 227 

Japanese, 227 
Aconitic acid, 227 
Aconitine, 227, 232 

Duquesnel's, 232 
Aconitum, 227 

Napellus, 227 



INDEX. 



565 



Acorin, 220 
Acorus calamus, 220 
Acrinyl sulphocyanide, 508 
Actual cautery, 39, 523 
Acupuncture, 33, 36 
Adeps, 540 

benzoinatus, 397, 441 
Adhesive plaster, 387 
Adonidine, 273 
Adonis vernalis, 273 
jfLsculin, 305 
^Ether, 103 

fortior, 103 
African capsicum, 215 

kino, 183 
Age, influence of, on medicinal effects, 61 
Alcohol, 55, 205 

amylic, 205, 300 

eery lie, 137 
Alcohol, diluted, 55, 209 

dilutum, 209 
Alcoholate of chloral, 283 
Alcoholic extract of belladonna, 93 
conium, 280 
hyoscyamus, 97 

extracts, 57 

potassa, 519 
Aldehyd, benzoic, 299 

of ethyl, 85 
Alder buckthorn, 342 
Ale, 211 

Alexandria senna, 340 
Algae, 537 
Alkali, volatile, 211 
Alkalies, 454 
Alkaline carbonates, 363, 455 

earths, 455 

preparations, 455 

sulphur ointment, 326 
Allium, 381 

sativum, 381 
Allspice, 218 
Allyl oxide, 38 1 

sulphide, 381 

sulphocyanide, 508 
Almond mixture, 529 

syrup, 300 
Aloe, 337 

Barbadensis, 338 

capensis, 338 

purificata, 339 

Socotrina, 337 

spicata, 338 

vulgaris, 338 
Aloes, 337, 399 

Barbadoes, 338 

Cape, 338 

hepatic, 338 

purified, 339 

Socotrine, 338 
Aloin, 338 



Alterative diaphoretics, 360 
Alteratives, 72, 403 
Althaea, 533 

officinalis, 533 
Alum, 203, 319, 523 

ammonio- ferric, 167 

dried, 203, 204 

whey, 204 
A lumen, 203 

exsiccatum, 204 
Aluminii sulphas, 204 
Aluminium sulphate, 204 
Amber, 129 
American hellebore, 232 

hemp, 99 

leech, 34 

lettuce, 84 

silver fir, 382 

white turpentine, 382 
American wormseed, 553 
Amidogen, 474 
Ammonia, 211 

preparations of, 211 
Ammoniac, 115, 399 

plaster, 11G 

with mercury, 116, 409, 412 
Ammoniacum, 115, 399 
Ammoniae, aqua, 213 

fortior, 212,517 

linimentum, 213, 510 

praeparata, 21 1 

spiritus, 213 

aromaticus, 213 
Ammoniated glycyrrhizin, 535 

mercury, 410, 420 

tincture of guaiac, 363 
valerian, 120 

tinctures, 54 
Ammonii acetatis, liquor, 247 

benzoas, 486 

bromidum, 290 

carbonas, 213 

chloridum, 450 

purificatum, 450 

iodidum, 430 

phosphas, 452 

praeparata, 462 

valerianas, 120 
Ammonio-ferric alum, 167 
Ammonium alum, 203 

benzoate, 486 

bromide, 290 

carbamate, 213 

carbonate, 213 

chloride, 450 

iodide, 430 

phosphate, 452 

preparations, 462 

sulphite, 471 

valerianate, 120 

elixir of, 120 (foot note) 



566 



INDEX. 



Amygdalate of tropine, 93 
Amygdalin, 300 
Amygdalus communis, 299 

var. Amara, 299 
Amyl hydrate, 300 

nitris, 300 

nitrite, 300 
Amylic alcohol, 205, 300 
Amylum, 538 

iodatum, 431, 540 
Anacardiaces, 383 
Anaesthetics, 72, 102 

local, 40, 112 
Anamirta paniculata, 259 
Andira araroba, 524 
Anemone patens, 237 

pratensis, 237 

Pulsatilla, 237 
Anemonic acid, 237 
Anemonin, 237 
Angelic acid, 310 
Aniline, 474, 482 
Animal fats, 540 
Anise, 226 

oil, 226 

star, 226 

water, 226 
Anisum, 226 

Anodyne, Hoffman's, 130 
Anodynes, 72 
Antacids, 72, 454 
Anthelmintics, 72, 551 
Antliemic acid, 138 
Anthemis, 138 

nobilis, 138 
Anthracene, 475 
Antidote for aconite, 229 

alcohol, 208 

antimony, 241 

arsenic, 444 

atropine, 91 

belladonna, 91 

boracic acid, 472 

boric acid, 472 

calabar bean, 282 

carbolic acid, 478 

chloral, 285 

colchicine, 372 

conium, 280 

copper, 195 

corrosive sublimate, 417 

daturine, 95 

digitalis, 271 

duboisine, 98 

hyoscine, 97 

hyoscyamine, 97 

hyoscyamus, 97 

iodine, 425 

lead, 191 

mercury, 417 

mineral acids, 169 



Antidote for morphine, 78 

opium, 78 

physostigma, 282 

prussic acid, 299 

silver salts, 199 

stramonium, 95 

strychnine, 255 

tartar emetic, 241 

vegetable acids, 249 

veratrine, 237 

veratrum viride, 235 

zinc, 196 
Antidotism, chemical, 49 

physiological, 49 
Antifebrin, 482 
Antilithics, 456 
Antimonial ointment, 518 

preparations, 241, 357 

powder, 244 

wine, 243 
Antimonii oxidum, 241 

et potassii tartras, 241 

sulphidum, 243 

purification, 243 

praeparata, 241 

sulphuratum, 243 
Antimonius oxide, 241 

sulphide, 243 

purified, 243 
Antimonium and potassium tartrate, 241 
Antimony, pills of, compound, 243 

preparations of, 241 

sulphurated, 243 

tartarized, 241 

wine of, 243 
Antiphlogistics, 404 
Antipyretics, 464 
Antipyrine, 476, 503 
Antiseptic oils, 505 
Antiseptics, 72, 464 
Antispasmodics, 72, 113 
Apiol, 402 

Apis mellifica, 542, 548 
Apocynaceae, 274, 374 
Apocynein, 374 
Apocynin, 374 
Apocynum, 374 

androsaemifolium, 374 

cannabinum, 374 
Apomorphinoe hydrochloras, 317 
Apomorphine, 317 

hydrochl orate, 317 
Aporetin, 336 
Apothecaries' measure, 60 

weight, 58 
Apple, 320 • 
Applications of medicines to the skin, 64 

to mucous membranes, 65 

to serous membranes, 69 

to ulcers, wounds, etc., 69 
Approximate measures, 61 



INDEX. 



567 



Aqua, 527 

ammoniae, 213 

fortior, 212, 517 

amygdalae amarae, 300 

anisi, 226 

aurantii florum, 223 

camphorae, 1 18 

chlori, 467 

cinnamomi, 217 

creosoti, 482 

destillata, 527 

foeniculi, 225 

menthae piperitae, 224 
viridis, 224 

rosae, 188 
Aquae, 53 

Aqueous extracts, 57 
Aqueous extract of aloes, 339 
Arabic acid, 529 
Arabin, 529 
Araceae, 220 
Araroba, 524 
Arbutin, 393, 394 
Arctostaphylos uva ursi, 393 
Argenti iodidum, 201 

nitras, 198 

diluius, 201, 519 
fusus, 201, 519 

oxidum, 201 

praeparata, 198 
Argol, 334 
Argyria, 199 
Aricine, 143 
Aristolochi a reticulata, 136 

serpentaria, 136 
Aristolochiaceae, 136 
Arnica, 238 

montana, 238 

flowers, 238 

root, 238 
Arnicae flores, 238 

radix, 238 
Arnicin, 238 
Aromatic bitters, 132, 136 

fluid extract, 220 

powder, 220 

series of carbon compounds, 473 

spirit of ammonia, 213, 462 

sulphuric acid, 1 70 

syrup of rhubarb, 337 

tincture of rhubarb, 337 

wine, 140, 224, 225 
Aromatics, 205, 214 
Arrack, 211 
Arseniate of sodium, 447 

solution of, 447 
Arsenic, 439 

eaters, 441 

iodide, 448 

metallic, 439 

preparations of, 439 



Arsenic, oxide, 439 

trisulphide, 440 

white, 439 
Arsenii et hydrargyri iodidi, liquor, 448 

iodidum, 448 

praeparata, 439 
Arsenious acid, 439, 521 
Arsenite of potassium, solution of, 446 
Artanthe elongata, 392 
Artanthic acid, 392 
Artemisia absinthium, 140 

maritima, 554 
Arteriotomy, 34 
Artificial camphor, 1 1 7 

musk, 129 
Asafetida, 113, 399 
Asafoetida, 113, 399 
Asagraea officinalis, 236 
Asparagin, 533, 535 
Aspidium, 556 

filix mas, 556 

marginale, 556 
Aspidol, 557 
Aspiration, 33, 36 
Aspirator, 36 
Astragalus gummifer, 530 
Astringent bitters, 132, 141 
Astringents, 72, 178 

mineral, 178, 189 

vegetable, 178, 179 
Atomization of fluids, 66 
Atomizers, 66 

Sajous' modification, 67 

Sass's, 68 

Siegele's, 68 

Snowden's, 67 
Atropa belladonna, 88 
Atropina, 88, 93 
Atropinae sulphas, 93 
Atropine, 88, 93 

sulphate of, 93 
Aurantiaceae, 223 
Aurantii amari cortex, 223 

dulcis cortex, 223 
Aurantii flores, 223 
Auric and sodium chloride, 423 
Auri et sodii chloridum, 423 
Aveling's apparatus for transfusion, 69 
Azedarach, 556 



Balm of Gilead tree, 382 
Balsam of copaiba, 388 

fir, 382 

Peru, 398 

Tolu, 398 
Balsamodendron myrrha, 396 
Balsams, 397 
Balsamum Peruvianum, 398 

Tolutanum, 398 
Bandages, 33, 35 



568 



INDEX. 



Barbadoes aloes, 338 

Barbaloln, 338 

Barbary gum, 528 

Barilla, 459 

Barium sulpho-carbolate, 480 

Barley, 211 

sugar, 548 
Barosma betulina, 393 

crenulata, 393 

serratifolia, 393 
Basham's mixture, 164 
Basic quinine sulphate, 150 

ferric sulphate, 161 
Basilicon ointment, 387 
Bassora gum, 529 
Baths, 39 

cold, 40 

hot, 39 

air, 39 
vapor, 39 

warm, 39 

of iodine, 428 

nitro-hydrochloric acid, 173 
sodium arseniate, 447 
Battery current, 42 
Baunscheidtismus, 36 
Bay rum, 211 
Bean of St. Ignatius, 257 

Calabar, 281 
Bearberry, 393 
Beberine, 392 
Bee, 542 

Beet-root sugar, 547 
Belladonna, 88 

leaves, 88 

root, 88 
Belladonnse folia, 88 

radix, 88 
Belladonnine, 89 
Bengal kino, 183 
Benjamin tree, 396 
Benne oil, 533 
Benzalcohol, 398 
Benzene, 475 
Benzine, 474, 476 
Benzoate of ammonium, 486 

benzyl, 398 

lithium, 462 

sodium, 486 
Benzol, 474, 476 
Benzyl-quinine, 476 
Benzyl- tropine, 476 
Benzoe amygdaloides, 397 

in sortis, 397 
Benzoic acid, 397 398, 475, 485 

aldehyde, 299 
Benzoin, 396 
Benzoinated lard, 397, 441 

ointment, 397, 441 
Benzoinum, 396 
Benzylic benzoate, 398 



Benzylic cinnamate, 398 
Berberaceae, 135 
Berberidacese, 345 
Berberine, 134, 135, 258, 364 

hydrochlorate, 135 

sulphate, 135 
Berzelius-Marsh test for arsenic, 441 
Beta-colchicoresin, 370 
Bhang, 99 
Bicarbonate of potassium, 456, 457 

sodium, 460 
Bichloride of methylene, no 

mercury, 409, 416, 468, 522 
Bichromate of potassium, 454, 522 
Bismuth and ammonium citrate, 202 

preparations of, 201 

subcarbonate, 202 

subnitrate, 201 

valerianate, 202 
| Bismuthi et ammonii, citras, 202 

prseparata, 201 

subcarbonas, 202 

subnitras, 201 
Bisulphate of quinine, 151 
Bisulphite of sodium, 471 
Bitartrate of potassium, 334 
Bitter almond water, 300 

cucumber, 350 

orange, 223 

wine of iron, 167 
Bittern, 330 
Bitters, aromatic, 132, 136 

astringent, 132, 141 

simple, 132 
Bittersweet, 102 
Black draught, 341 

drop, 83 

ginger, 219 

haw, 307 

oxide of manganese, 168 

mustard, 507 

pepper, 216, 511 

poppy, 73 

snakeroot, 276 

wash, 414 
Blackberry, 1 88 

Blennorrheas, 72, 365, 367, 378, 399 
Blistering cerate, 515 
Blisters, 506, 512 
Bloodletting, 33, 34, 399 
Bloodroot, 315 
Blue-flag, 348 
Blue gum-tree, 137 

mass, 354, 355 

ointment, 404, 411 

pill, 354, 355 

stone, 196 

vitriol, 196 
Boheic acid, 121 
Bolus, 52 
Bone ash, 175 



INDEX. 



569 



Bone-ash phosphate of calcium, 448 

Boneset, 139 

Boracic acid, 471 

Borate of sodium, 473 

Borated cotton, 268 

Borax, 473 

Bordeaux turpentine, 382 

Boric acid, 471 

Borneo camphor, 116 

Boro-cotton, 268 

Botany Bay kino, 183 

Bran, 320 

Brandy, 210 

Brayera, 558 

anthelmintica, 558 
Brazilian sarsaparilla, 360 
Brimstone, 325 
British barilla, 459 
Bromide of ammonium, 290 

calcium, 291 

ethyl, 112 

lithium, 291 

sodium, 291 

potassium, 286 

zinc, 291 
Bromides, 286 
Bromine, 470, 521 
Bromism, 288 
Bromum, 470, 521 
Broom, 275, 377 
Brown mixture, 536 
Brucine, 252, 253, 257 
Bryonia, 344 

alba, 344 

dioica, 344 
Bryonin, 345 
Bryony, 344 
Buchu, 393 
Buckthorn, 342 
Burgundy pitch, 510 

plaster, 511 

spurious, 510 
Burnett's disinfectant fluid, 198 
Burseracese, 396 
Butea frondosa, 183 
Butter, melted, 325 

of cacao, 542 
Butternut, 337 
Butyric acid, 353 



Cacao butter, 542 

Caffea, 121 

Caffeic acid, 121 

Caffeina, 122 

Caffeine, 121, 122, 128 
citrate, 122 
valerianate, 122 

Caffeo-tannic acid, 121 

Cajeput oil, 218 

Cake gamboge, 351 



Calabar bean, 281 
Calabarine, 281 
Calamus, 220 
Calcii bromidum, 291 

carbonas praecipitatus, 463 

chloridum, 450 

hypophosphis 449 

phosphas prgecipitatus, 448 

prseparata, 462 
Calcined magnesia, 329 
Calcium bromide, 291 

chloride, 450 

hypophosphite of, 449 

phosphate, precipitated, 448 

precipitated carbonate of, 463 
phosphate of, 448 

preparations of, 462 

sulphide, 327 

sulphite, 327, 471 

sulpho-carbolate, 480 
Calendula, 364 

officinalis, 364 
Calendulin, 364 
Calisaya bark, 142 
Calomel, 354. 355, 409, 414, 558 

Howard's, 414 

Jewell's, 414 
Calor, 39 
Calumb, 134 
Calumba, 134 
Calx chlorata, 467 

sulphurata, 471 
Cambogia, 351 
Cambogic acid, 351 
Campeachy-wood, 185 
Camphor, 1 16 

artificial, 117 

Borneo, 116 

cerate, 118 

China, 116 

crude, 116 

Dutch, 116 

Japan, 116 

laurel, 116 

liniment, 118 

mixture, Hope's, 118 

monobromated, 119 

refined, 116 

Sumatra, 116 

water, 118 
Camphora, 116 
Camphora Cinnamomum, 116 

monobromata, 119 
Camphorated tincture of opium, 83 
Camphoric acid, 117 
Camphoronic acid, 117 
Canada balsam, 382 

fleabane, 373 

moonseed, 364 

pitch, 511 

plaster, 511 



57o 



INDEX. 



Canada turpentine, 382 
Canadian hemp, 373 
Candy, rock, 548 
Cane sugar, 547, 548 
Cannabinine, 100 
Cannabin, 100 
Cannabis Americana, 99 

Indica, 99 

sativa, 99 
Cannabene, 100 

hydride, 1 00 
Cantharidal collodion, 516 

liniment, 516 
Cantharidin, 514, 518 
Cantharides, 377, 399, 513 

cerate of, 515 

paper of, 517 
Cantharidic acid, '514 
Cantharis, 377, 513 

vesicaloria, 513 

viltata, 517 
Cape aloes, 338 
Caprifoliacese, 307 
Capsaicin, 215 
Capsicum, 215, 510 

African, 215 

fastigiatum, 215 
Capsules, gelatin, 52 
Caraccas kino, 183 
Caraway, 226 
Carbo ligni, 549 
Carbolate of potassium, 480 

quinine, 151 

sodium, 480 
Carbolic acid, 474, 476 

crude, 476 

ointment of, 480 
Carbolized cotton, 268 
Carbon-compounds, aromatic series of, 474 
Carbonate of ammonium, 213, 462 

calcium, precipitated, 463 

iron, pill of, 160 

saccharated, 160 

lead, 194 

lithium, 461 

magnesium, 330, 462 

potassium, 456, 457 
pure, 457 

sodium, 459 
dried, 460 

zinc, precipitated, 197 
Carbonates of sodium, 459-460 
Carbonic acid water, 528 
Carboxyl, 475 
Cardamom, 219 
Cardamomum, 219 
Carica papaya, 157 
Carminatives, 205, 214 
Carminic acid, 551 
Carolina pink, 551 

jasmine, 304 



Carrageenin, 538 
Carron oil, 463 
Carthagena barks, 143 
Carum, 226 

carvi, 226 
Caryophyllin, 218 
Caryophyllus, 218 

aromaticus, 218 
Cascara sagrada, 342 
Cascarilla, 141 
Cascarillin, 141 
Cassia, 339 

acuti folia, 340 

sethiopica, 340 

cinnamon, 216 

elongata, 340 

Fistula, 323 

lanceolata, 340 

obovata, 340 
Castanea, 189 

vesca, 189 
Castor oil, 323 
Cataplasmata, 58, 526 
Cataplasms, 50, 58 
Catechin, 183 
Catechu, 182 

red, 183 
Catechu-tannic acid, 183 
Cathartic acid, 340 
Cathartics, 72, 319 
Catharto-mannit, 341 
Caustic potassa, 519 

soda, 520 
Cauterants, 518 
Cauterization, 39 
Cautery, actual, 39, 523 

galvano, 45 
Cayenne pepper, 215 
Cedar, red, 400 
Celandine, 347 
Celastraceae, 348 
Centigram, 59 

Cephaelis Ipecacuanha, 312 
Cera alba, 542 

flava, 542 
Cerata, 57 
Cerate, 57, 541 

blistering, 515 

camphor, 118 

cantharides, 515 

carbonate of zinc, 196, 197 

extract of cantharides, 5^ 

Goulard's, 193 
Cerate, lead, subacetate, 193 

savine, 400 

spermaceti, 542 

resin, 387 

compound, 387 
Cerates, 50, 57 
Ceratum, 57, 541 

camphors, 1 18 



INDEX. 



571 



Ceratum, cantharidis, 515 

cetacei, 542 

extracti cantharidis, 516 

plumbi subacetatis, 193 

resinge, 387 

sabinae, 400 
Cerii oxalas, 202 
Cerite, 202 
Cerium, nitrate, 203 

oxalate, 202 
Cerylic alcohol, 137 
Cetacea, 541 
Cetaceum, 541 
Cetin, 541 
Cetraria, 536 

islandica, 536 
Cetraric acid, 537 
Cetrarin, 537 
Cetyl palmitate, 541 
Ceylon cinnamon, 216 
Chalk, 464 

mixture, 464 

powder, compound, 464 

prepared, 464 

troches of, 464 
Chalybeates, 157, 403 
Chamomile, 138 

German, 139 
Champagne, 210 
Chapman's copaiba mixture, 389 (foot- 

note) 
Charcoal, 549 

poultice, 527 
Chart a cantharidis, 517 

potassii nitratis, 246 

sinapis, 509 
Chartse, 52 
Chelerythrine, 348 
Chelidonine, 348 
Chelidoninic acid, 348 
Chelidonium, 347 

majus, 347 
Chemical antidotism, 49 
Chenopodiaceae, 553 
Chenopodium, 553 

ambrosioides, 553 
Chestnut, 189 
Chian turpentine, 382, 383 
Chimaphila, 394 

maculata, 394 

umbellata, 394 
Chimaphilin, 394 
China camphor, 116 

cinnamon, 216 

musk, 129 
Chinese oil of peppermint, 224 

rhubarb, 335 
Chinocine, 475 
Chinoidin, 152 
Chinoidinum, 152 
Chinoline, 475, 498 



Chirata, 135 
Chiratin, 136 
Chittem bark, 342 
Chloral, 283 

alcoholate, 283 

hydrate, 283 
Chlorate of potassium, 452 

sodium, 454 
Chlorhydric acid, 272 

diluted, 272 
Chloride of ammonium, 450 

calcium, 450 

gold and sodium, 423 

iron, 162 

solution of, 163 
tincture of, 163 

lime, 467 

mercury ; corrosive, 409, 416, 468 
mild, 354,355,409, 414 

zinc, 198, 522 

solution of, 197 
Chlorinated lime, 467 

soda, solution of, 468 
Chlorine, 467 

water, 467 
Chlorodyne, 1 10 (foot-note) 
Chloroform, 102, 107 

commercial, 107 

liniment, no 

purified, 107 
Chloroformum, 107 

purificatum, 107 

venale, 107 
Chocolate, 122 
Chocolate nuts, 543 
Choke-cherry, 154 

Cholagogues, mercurials as, 354, 417 
Choline, 100 

Chondodendron tomentosum, 392 
Chondrus, 537 

crispus, 537 

mammilosus, 538 
Chrome-ironstone, 454 
Chromic acid, 520 

anhydride, 520 
Chromium, 454 
Chiomogene, 267 
Chrysarobin, 336, 524 
Chrysarobinum, 524 
Chrysophan, 336, 341 
Chrysophanic acid, 336, 524 
Churrus, 99 
Cicuta, 280 
Cimicifuga, 276 

racemosa, 276 
Cinchona, 141 

calisaya, 142 

flava, 142 

micrantha, 142 

officinalis, 142 

ovata, 142 



572 



INDEX. 



Cinchona, rubra, 142 

succirubra, 142 
Cinchonese, 141 
Cinchonicine, 143 
Cinchonidina, 143, 144 
Cinchonidinse sulphas, 152 
Cinchonidine, 143, 144 

sulphate, 152 
Cinchonina, 143 
Cinchoninse sulphas, 152 
Cinchonine, 143, 144 

sulphate, 152 
Cincho-tannic acid, 143 
Cinnabar, 404, 422 
Cinnamate of benzyl, 398 
Cinnamein, 398 
Cinnamic acid, 217, 397, 398 
Cinnamomum, 216 

zeylanicum, 216 
Cinnamon, 216 

cassia, 216, 217 

Ceylon, 216 

China, 216 

water, 217 
Circumstances modifying the effects of 

medicines, 4g 
Cissampeline, 392 
Citrate of bismuth and ammonium, 202 

caffeine, 122 

iron, 165 

wine, 167 

and ammonium, 167 

and quinine, 166 

solution of, 167 

and strychnine, 167 

solution of, 165 

lithium, 461 

magnesium, solution of, 331 
granulated, 331 

potassium, 247 

mixture of, 247 
solution of, 247 

quinine, 151 
Citric acid, 250 

syrup of, 250 
Citrine ointment, 410, 423 
Citrullus Colocynthis, 350 
Citrus aurantium, 223 

Limonum, 250 

vulgaris, 223 
Clarified honey, 548 
Classification of medicines, 70 
Claviceps purpurea, 260 
Climate, influence of, on medicinal 
effects, 63 

on plants, 49 
Cloves, 218 
Club moss, 536 
Clysters, 68 
Coca, 122 
Cocaine, 122, 123 



Cocaine, hydrochlorate, 123 
Cocatannic acid, 122 
Coccoloba uvifera, 183 
Cocculus Indicus, 259. 

palmatus, 134 
Coccus, 550 

cacti, 550 
Cochineal, 550 
Codamine, 74 
Codeina, 75, 84 
Codeine, 74, 75, 84 
Cod-liver oil, 436 

phosphorated, 439 
Coffea arabica, 121 
Coffee, 121 
Cohosh, 276 
Colchiceine, 370 
Colchici radix, 369 

semen, 369 
Colchicine, 370, 373 
Colchico-resin, 370 
Colchicum, 369 

autumnale, 369 

root, 369 

seed, 369 
Cold, 38, 40 

bath, 40 

compresses, 41 

cream, 188 

douche, 40 

injections, 41 

liquids, 41 

pack, 40 

wet sheet, 40 
Coleoptera, 513 
Colica Pictonum, 190 
Collodion, 546 

flexible, 546 

iodized, 546 

styptic, 546 

with cantharides, 516 
Collodium, 546 

flexile, 546 

stypticum, 546 

cum cantharide, 516 
Collyria, 66 
Colocynth, 350 
Colocynthin, 350 
Colocynthis, 350 
Colocynthitin, 350 
Colombin, 134 
Cologne water, 225 
Coloring agents, 72, 550 
Columbian bark, 143 
Columbic acid, 134 
Columbo, 134 
Combe, 274 
Commercial chloroform, 107 

quinidine, 145 

sodium bicarbonate. 460 

zinc oxide, 197 



INDEX. 



573 



Common cod, 436 

Composite, 84, 138, 139, 140, 238, 308, 

3 6 4, 373. 375. 401, 554 
Compound cathartic pills, 352 
chalk powder, 464 
decoction of sarsapar ilia, 361 
effervescing powder, 335 
extract of colocynth, 350, 351 
fluid extract of sarsaparilla, 362 
glycyrrhiza mixture, 536 

powder, 341 
infusion of senna, 341 
iron mixture, 161, 396 

pills, 161, 396 
jalap powder, 344 
liquorice mixture, 536 
liniment of mustard, 509 
mixture of glycyrrhiza, 536 
iron, 161, 396 
liquorice, 536 
pills of antimony, 243 
galbanum, 115, 396 
iron, 161, 396 
rhubarb, 337 
powder of glycyrrhiza, 341 
jalap, 344 
liquorice, 341 
morphine, 84 
rhubarb, 337 
resin cerate, 387 
solution of iodine, 427 
spirit of ether, 130 

juniper, 377 
syrup of sarsaparilla, 361 

squill, 369, 380 
tincture of benzoin, 397, 399 
cardamom, 220 
catechu, 183 
cinchona, 149 
gentian, 134 
iodine, 427 
lavender, 223 
Compressed pills, 52 
Compresses, cold, 41 
Condition of alimentary canal influences 

action of medicine, 63 
Condy's fluid, 467 
Confectio rosae, 188 

. sennae, 341 
Confection, rose, 188 

senna, 321, 323, 341 
Confectiones, 52 
Confections, 50, 52 
Conhydrine, 279 
Conidia, 261 

Coniferse, 376, 382, 400, 510, 51 1 
Conine, 278 

hydrate, 279 
Conium, 278 

maculatum, 278 
Conserves, 52 



Continuous electrical current, 42 
Convolvulaceae, 343, 349 
Convolvulin, 344 
Convolvulus Scammonia, 349 
Copaiba, 387 
Copaifera, 387 

Langsdorffii, 387 
Copaivic acid, 388 
Copper acetate, 196 

preparations of, 195 

sulphate of, 196, 318, 523 
Copperas, 161 
Coriander, 226 
Coriandrum, 226 

sativum, 226 
Corn ergot, 266 

smut, 266 
Cornaceae, 153 
Cornic acid, 153 
Cornin, 153 
Cornutin, 263 
Cornus, 153 

circinata, 153 

florida, 153 

sericea, 153 
Corpuscles of Laveran, 148 
Corroborants, 13 1 

Corrosive chloride of mercury, 409, 416, 
468, 522 

mercurial chloride, 409, 416, 468, 522 

sublimate, 409, 416, 468, 522 
Cosmoline, 545 
Cotton, 268 

borated, 268 

boro-, 268 

carbolized, 268 

iodo-, 268 

iodoform, 268 

root, bark of, 268 

salicylated, 268 

seed oil, 532 

sublimated, 268 
Couch-grass, 376 
Court-plaster, 540 
Cowling's scheme for doses, 63 
Cox's hive syrup, 369 
Cracked wheat, 320 
Cranesbill, 186 

Cream of tartar, 250, 251, 334, 366 
Creasol, 480 
Creasote, 385, 480 

water, 482 
Creasotum, 480 
Cresol, 480 
Creta praeparata, 464 
Crocus, 550 

sativus, 550 
Croton-chloral hydrate, 286 
Croton Eluteria, 141 

oil, 353, 5*8 

Tiglium, 353 



574 



INDEX. 



Crowfoot, 1 86 
Cruciferae, 318, 507 
Crude carbolic acid, 476 

camphor, 1 1 6 

liquorice, 534 

quinine, 152 

sulphur, 325 

tartar, 334 
Cryolite, 459 
Cryptopine, 74, 76 
Cubeb, 389 
Cubeba, 389 

officinalis, 389 
Cubebic acid, 390 
Cubebin, 390 
Cubic centimeter, 59 

nitre, 246 
Cuca, 122 
Cucaine, 123 
Cucumber, bitter, 350 

squirting, 352 
Cucurbita pepo, 559 
Cucurbitaceae, 344, 350, 352, 559 
Cultivation, influence of, on plants, 49 
Culver's root, 34 1 

physic, 341 
Cupping, 35 

dry, 35 

glasses, 35 

wet, 35 
Cupri acetas, 196 

praeparata, 195 

sulphas, 196, 523 
Cupric sulphate, 196, 523 
Cups, 33, 35 

Cupulilerae, 181, 185, 189 
Curare, 306 
Curarine, 306, 307 
Curine, 306 
Cut cups, 35 
Cyanide of potassium, 299 

mercury, 410, 421 
Cyanhydric acid, 296 
Cydonia vulgaris, 534 
Cydonium, 534 
Cymene, 225 
Cymol, 117, 137 
Cymylic phenol, 505 
Cynips quercusfolii, 181 
Cypripedium, 120 

parvifiorum, 120 

pubescens, 120 



Dandelion, 375 

Daphne mezereum, 363 

Daphnin, 363 

Darkness, 39 

Datura stramonium, 94 

Daturine, 95 

Deadly nightshade, 88 



Decagram, 59 

Decigram, 59 

Decimal system, 59, 60 

Decocta, 54 

Decoction of azedarach, 556 

althaea, 534 

aspidium, 558 

broom, 377 

cetraria, 537 

chondrus, 538 

geranium, 187 

glycyrrhiza, 535 

haematoxylon, 185 

Iceland moss, 537 

Irish moss, 538 

liquorice- root, 535 

logwood, 185 

marsh-mallow, 533 

oak, 186 

poppies, 73 

sarsaparilla, compound, 361 

stillingia, 365 
Decoctions, 50, 54 
Decoctum cetrariae, 537 

sarsaparillae compositum, 361 
Deer berry, 220 
Delphinine, 240 
Delphinium staphisagria, 240 
Delphinoidine, 240 
Delphisine, 240 
Demulcents, 72, 525 
Denarcolized opium, 82 
Deodorized tincture of opium, 83 
Depresso-motors, 251, 278 
Derivatives of phenyl, 473 
Deshler's salve, 387 
Deuteropine, 74 
Dewberry, 188 
Dewees's carminative, 336 
Diachylon, 194 

ointment, 194 
Dialysis, 54 

Dialyzed iron, 167, 444 
Dialyzer, 54 
Diaphoretics, 72, 356, 365, 399 

alterative, 360 

nauseating, 357 

refrigerant, 357, 365 

stimulating, 357, 367 
Diastase, 539 
Dichloromeihane, 1 10 
Dieulafoy's aspirator, 36 
Diffusible stimulants, 205 
Digestion, 53 

influence on medicinal effect, 63 
Digestive ferments, 155 
Digitalein, 269 
Digitalin, 269 
Digitalis, 268, 367 

purpurea, 268 
Digitonin, 269 



INDEX. 



575 



Digitoxin, 269 

Diluents, 525 

Diluted acetic acid, 249 

alcohol, 55, 209 

hydrobromic acid, 291 

hydrochloric acid, 172 

hydrocyanic acid, 296 

muriatic acid, 172 

nitric acid, 171 

nitro-hydrochloric acid, 173 

nitro-murlatic acid, 173 

phosphoric acid, 174 

solution of subacetate of lead, 193 

silver nitrate, 201, 519 

sulphuric acid, 170 
Diplolepis gallse tinctorise, 181 
Dipterocarpaceae, 116 
Disease, influence of, on medicinal ef- 
fects, 63 
Disinfecting fluid, Burnett's, 198 
Condy's, 467 
Le doyen's, 194 

solution, Labarraque's, 468 
Dispensatory, 47 
Displacement, 53 
Distilled oils, 214 

water, 527 

waters, 53 
Diuretics, 72, 365 
Dobell's solution, 67 
Dogsbane, 375 
Dogwood, 153 

round leaved, 153 

swamp, 153 
Dolomite, 330 
Donovan's solution, 448 
Dorema ammoniacum, 115, 310 
Doses, modifying effects of, 49 

of medicines, 63 
Douche, 40 

Dover's powder, 82, 315, 357 
Drachm, 58, 59 
Drastic cathartics, 319, 343 
Drastics, 319 
Draught, black, 341 

effervescing, 247 

Scud am ore's, 372 
Dried alum, 204 

ferrous sulphate, 162 

sodium carbonate, 460 
Drops, 60 

Dryobalanops camphora, 116 
Duboisia, 98 

myoporoides, 98 
Duboisine, 98 
Dulcamara, 102 
Dulcamarin, 102 
Dupuytren's pomatum, 517 
Duquesnel's aconitine, 232 
Dutch camphor, 116 
Dynamite, 302 



East India kino, 183 
Ecballium Elaterium, 352 
Eccritics, 72, 310 
Ecgonine, 123 
Effects of medicines, 49 

the potassium salts, 245 
Effervescing draught, 247 

powder; compound, 335 
Effleurage, 45 
Egyptian opium, 74 
Elaidin, 422 
Elaterin, 352 
Elaterinum, 352 
Elaterium, 352 
Electric bath, 41 

battery, 41, 42 

elements, 42 

machine, 41 

shock, 41 

spark, 41 
Electricitas, 41 
Electricity, $8, 41 

faradic, 41, 42 

frictional, 41 

galvanic, 41 

induced, 41, 42 

magnetic, 41, 42 

static, 41 

voltao- magnetic, 41, 42 
Electro-magnetic machine, 42 
Electrodes, 42 
Electrolysis, 44 
Electuaries, 52 
Elettaria Cardamomum, 219 
Elixir of ammonium valerianate, 120 (foot- 
note) 

aurantii, 223 

of orange, 223 

of vitriol, 170 

simple, 223 
Ellis's magnesia, 329 
Elm, 532 
Elutriation, 51 
Emetics, 72, 310 

local, 310 

mineral, 318 

systemic, 310 

vegetable, 312 
Emetine, 313 
Emmenagogues, 72, 3gg 
Emodin, 336, 342 
Emollients, 525 
Emplastra, 58 
Emplastrum ammoniaci, 116 

cum hydrargyro, 116, 409, 41 1 

arnicae, 238 

asafcelidae, 1 15 
Emplastrum belladonnae, 93 

capsici, 216, 510 

feiri, 161 

galbani, 115 



576 



INDEX. 



Emplastrum hydrargyri. 409, 411 

ichthyocollae, 540 

opii, 82 

picis Burgundicae, 511 
Canadensis, 511 
cum cantharide, 511 

plumbi, 58, 194 

resinae, 387 

saponis, 194 
Emulsin, 300 
Emulsions, 52 

Endermic application of medicines, 64 
Enemata, 68, 355 

cathartic, 355 

forced, 356 

laxative, 355 

nutritive, 68 
Enepidermic application of medicines, 64 
English rhubarb, 335 
Epidermic application of medicines, 64 
Epispastics, 377, 506, 512 
Epsom salt, 330 
Ergot, 260 

of rye, 260 

corn, 266 
Ergot a, 260 
Ergotin, 266 
Ergotinic acid, 262 
Ergotinine, 263 
Ericaceae, 220, 393, 394 
Ericolin, 393 
Erigeron canadense, 373 
Errhines, 66 
Eruic acid, 508 
Erythroretin, 336 
Erythroxylaceae, 122 
Erythroxylon, 122 

coca, 122 
Eschar, 518 
Escharotics, 506, 518 
Eserine, 281, 283 

salicylate, 283 
Essence of lemon, 250 

mirbane, 482 

peppermint, 224 

spearmint, 224 
Essential oils, 214 
Ethal alcohol, 542 
Ether, 103 

methylic, in 

cenanthic, 210 

stronger, 103 
Ethereal anaesthetics, 102 

oil, 130 

refrigerants, 248, 366 

tinctures, 55 
Ethyl, 103 

aldehyd, 85 

bromide, 1 12 

carbamate, 87 

hydrate, 205 



Ethyl, nitrite, 248 

oxide, 103 
Eucalyptol, 137, 138 
Eucalyptus, 137 

globulus, 137 

resinifera, 183 
Eugenia caryophyllata, 218 

Pimenta, 218 
Eugenic acid, 218 
Eugenin, 218 
Eugenol, 218 
Euonic acid, 349 
Euonymin, 349 
Euonymus, 348 

atropurpureus, 348 
Eupatorin, 140 
Eupatorium, 139 

aromaticum, 140 

perfoliatum, 139 

teucrifolium, 140 
Euphorbiaceae, 141, 323, 353, 365, 559 
European leech, 34 

opium, 74 

rhubarb, 335 
Evacuants, 310, 399 
Excito-motors, 251 
Exogonium Purga, 343 
Expectorants, 378 
Expressed oil of almond, 323 
Extract, aromatic fluid, 220 

of aconite, 232 
fluid, 232 

aloes, aqueous, 339 

American hellebore, fluid, 236 

arnica root, 238 
fluid, 238 

belladonna, alcoholic, 93 
root, fluid, 93 

bitter-orange peel, fluid, 223 

bittersweet, fluid, 102 

blackberry, fluid, 189 

brayera, fluid, 559 

broom, fluid, 377 

buchu, fluid, 393 

butternut, 337 

calabar bean, 283 

calamus, fluid, 220 

calumba, fluid, 135 

cannabis indica, 99 
fluid, IOI 

castanea, fluid, 189 

capsicum, fluid, 216 

cascara sagrada, fluid, 343 

chestnut leaves, fluid, 189 

chimaphila, fluid, 395 

chirata, fluid, 136 

cimicifuga, fluid, 278 

cinchona, 149 
fluid, 149 
Extract of coca, fluid, 123 

colchicum root, acetic, 373 



INDEX. 



577 



Extract of colchicum, fluid, of root, 373 
of seed, 373 
colocynth, 351 

compound, 350, 351 
columbo, fluid, 135 
conium, 280 

fluid, 280 
cornus, fluid, 154 
cotton-root bark, fluid, 268 
couch grass, fluid, 376 
cubeb, fluid, 391 
cypripedium, fluid, 120 
dandelion, 376 

fluid, 376 
digitalis, 273 

fluid, 273 
dogwood, fluid, 154 
dulcamara, fluid, 102 
ergot, 266 

fluid, 266 
erythroxylon, fluid, 123 
eucalyptus, fluid, 137 
euonymus, 349 
eupatorium, fluid, 140 
frangula, fluid, 342 
gelsemium, fluid, 306 
gentian, 134 

fluid, 134 
geranium, fluid, 187 
ginger, fluid, 219 
glycyrrhiza, 535 

fluid, 535 

refined, 535, 536 
Goulard's, 193 
grindelia, fluid, 309 
guarana, fluid, 128 
hsematoxylon, 185 
hamamelis, fluid, 188 
hemp, 99 

fluid, 101 
hydrastis, fluid, 259 
hyoscyamus, alcoholic, 97 

fluid, 97 
Indian hemp, 99 

fluid, 101 
ipecac, fluid, 315 
iris, 348 

fluid, 348 
jaborandi, fluid, 360 
juglans, 337 
koosso. fluid, 559 
krameria, 184 

fluid, 184 
lactucarium, fluid, 84 
leptandra, 342 

fluid, 342 
liquorice root, 535 

fluid, 535 

refined, 535, 536 
lobelia, fluid, 296 
logwood, 185 

37 



Extract of lupulin, fluid, 102 
malt, 211 
matico, fluid, 392 
May-apple, 347 

fluid, 347 
mezereon, 363 

fluid, 363 
nux vomica, 257 

fluid, 257 
opium, 82 
pareira, fluid, 392 
pepo, fluid, 560 
physostigma, 283 
pilocarpus, 360 
pipsissewa, fluid, 395 
podophyllum, 347 

fluid, 347 
prunus virginiana, fluid, 155 
pumpkin-seed, fluid, 560 
quassia, 133 

fluid, 133 
rhatany, 184 

fluid, 184 
rhubarb, 336 

fluid, 336 
rhus glabra, fluid, 188 
rose, fluid, 188 
rubus, fluid, 189 
sanguinaria, fluid, 317 
sarsaparilla, fluid, 362 

fluid, compound, 362 
savine, fluid, 400 
Scutellaria, fluid, 121 
senega, fluid, 380 
senna, fluid, 341 
serpentaria, fluid, 137 
spigelia, fluid, 553 
squill, fluid, 369 
stillingii, fluid, 365 
stramonium, 95 

fluid, 95 
sumach, 188 
taraxacum, 376 

fluid, 376 
triticum, fluid, 376 
uva ursi, fluid, 394 
valerian, fluid, 1 20 
veratrum viride, fluid, 236 
virburnum, fluid, 308 
wahoo, 349 
witchhazel, fluid, 188 
wild cherry, fluid, 155 
yellow jasmine, fluid, 306 
Extracta, 57 

fluida, 56 
Extracts, 50, 57 
fluid, 50, 56 
watery, 57 
alcoholic, 57 
acetic, 57 
Extractum aconiti, 232 



578 



INDEX. 



Extractum aconiti fluidum, 232 
aromaticum fluidum, 220 
aloes aquosum,339 
arnicae radicis, 238 

fluidum, 238 
aurantii amari fluidum, 223 
belladonnas alcoholicum, 93 

fluidum, 93 
bray eras fluidum, 559 
buchu fluidum, 393 
calami fluidum, 220 
calumbse fluidum, 135 
Cannabis indicas, 99 

fluidum, 101 
capsici fluidum, 216 
castaneas fluidum, 189 
chimaphilae fluidum, 395 
chiratae fluidum, 136 
cimicifugas fluidum, 278 
cincbonae, 149 

fluidum, 149 
cokhici, 373 

radicis fluidum, 373 

semims fluidum, 373 
colocyntbidis, 351 

compositum, 351 
conii alcoholicum, 280 

fluidum, 280 
cornus fluidum, 154 
cubebae fluidum, 391 
cypripedii fluidum, 120 
digitalis, 273 

fluidum, 273 
dulcamarae fluidum, 102 
ergotae, 266 

fluidum, 266 
erythroxyli fluidum, 123 
eucalypti fluidum, 137 
euonymi, 349 
eupatorii fluidum, 140 
frangulae fluidum, 342 
gelsemii fluidum, 306 
gentianae, 134 

fluidum, 134 
geranii fluidum, 187 
glycyrrbizae, 535 

fluidum, 535 

purum, 535, 536 
gossypii radicis fluidum, 268 
grindeliae fluidum, 309 
guaranae fluidum, 128 
haematoxyli, 185 
bamamelidis fluidum, 188 
bydrastis fluidum, 259 
byoscyami alcoholicum, 97 

fluidum, 97 
ipecacuanhas fluidum, 315 
iridis, 348 

fluidum, 348 
juglandis,337 
krameriae, 184 



Extractum krameriae fluidum, 184 
lactucarii fluidum, 84 
leptandrae, 342 

fluidum, 342 
lobeliae fluidum, 296 
lupulini fluidum, 102 
malti, 211 
matico fluidum, 392 
mezerei, 363 

fluidum, 363 
nucis vomicae, 257 

fluidum, 257 
opii, 82 

pareirae fluidum, 392 
physostigmatis, 283 
pilocarpi fluidum, 360 
podophylli, 347 

fluidum, 347 
pruni Virginanas fluidum, 155 
quassias, 133 

fluidum, 133 
rhei, 336 

fluidum, 336 
rhois glabrae fluidum, 189 
rosae fluidum, 188 
rubi fluidum, 189 
sabinae fluidum, 400 
sanguinariae fluidum, 317 
sarsaparillae fluidum, 362 

compositum fluidum, 362 
scillae fluidum, 369 
Scutellariae fluidum, 121 
senegas fluidum, 380 
sennas fluidum, 341 
serpentarias fluidum, 137 
spigelias fluidum, 553 
stillingias fluidum, 365 
stramonii, 95 

fluidum, 95 
taraxaci, 376 

fluidum, 376 
tritici fluidum, 376 
uvae ursi fluidum, 394 
Valerianae fluidum, 120 
veratri viridis fluidum, 236 
viburni fluidum, 308 
zingiberis fluidum, 219 
Eye-washes, 66 



False angustura bark, 251 

Farad ic electricity, 41, 42 

Faradization, 41,42 

Fasting, influence on medicinal effect, 63 

Fat manna, 321 

Fennel, 225 

oil, 225 

water, 225 
Fern, male, 556 
Ferri carbonas saccharatus, 1 60 

carbonatis, massa, 161 



INDEX. 



579 



Ferri chloridi, liquor, 163 

tinctura, 163 
chloridum, 162 
citras, 165 
citratis, liquor, 165 
et ammonii acetatis, mistura, 164 
et ammonii citras, 167 
et ammonii sulphas, 167 
et ammonii tartras, 167 
et potassii tartras, 164 
et quininae citras, 166 

liquor, 167 
et strychninse citras, 167 
hypophosphis, 165, 450 
iodidi, syrupus, 164 
iodidum saccharatum, 164 
lactas, 166 
nitratis, liquor, 165 
oxalas, 166 
oxidum hydratum, 160, 444 

cum magnesia, 160, 444 
phosphas, 165 
praeparata, 157 
pyrophosphas, 165 
subsulphatis, liquor, 162 
sulphas, 161 

exsiccatus, 162 

praecipitatus, 162 
Ferri tersulphatis, liquor, 162 

valerianas, 167 
Ferric acetate, solution of, 166 

tincture of, 166 
chloride, 162 

solution of, 163 

tincture of, 163 
citrate, 165 

solution of, 165 
citro-chloride, 163 
hydrate, 160,444 
hypophosphite, 165, 450 
nitrate, solution of, 165 
oxide, 159 

hydrated, 160,444 

with magnesia, 160, 444 
phosphate, 165 
pyrophosphate, 165 
sulphate, 162 

solution of basic, 162 
normal, 162 
valerianate, 167 
Ferrous bromide, syrup of, 166 
carbonate, 160 

mass of, 161 

saccharated, 160 
iodide, pills of, 164 
Ferrous iodide, saccharated, 164 

syrup of, 164 
lactate, 166 
oxalate, 166 
sulphate, 161 

dried, 162 



P'errous sulphate, precipitated, 162 
Ferruginea, 157, 399 
Ferrum, 157 

dialysatum, 167 

reductum, 160 
Ferula galbaniflua, 115 

Narthex, 113 

Scorodosma, 113 

Sumbul, 309 
Ferulaic acid, 113 
Ficus, 320 
Fig, 320 
Filices, 556 
Filicic acid, 557 
Filix mas, 556 
Fir, balsam of, 382 

silver, 382 
Flake manna, 321 \ 

Flax, common, 530 
Flaxseed, 530 

meal, 531 

oil, 325, 53 1 

poultice, 531 

Flexible collodion, 546 

Flour of mustard, 507 

Flowers of orange, 223 

of sulphur, 325 
Fluid, Burnett's disinfecting, 198 
Condy's disinfecting, 467 
extract, aromatic, 220 

of aconite, 232 

arnica root, 238 

belladonna, 93 

bitter orange peel, 223 

blackberry, 189 

bray era, 559 

broom, 377 

buchu, 393 

calamus, 220 

calumba, 134 

cannabis Indica, 101 

capsicum, 215 

cascara sagrada, 342 

castanea, 189 

chestnut leaves, 189 

chimaphila, 395 

chirata, 136 

cimicifuga, 278 

cinchona, 149 

coca, 123 

colchicum root, 373. 
seed, 373 

conium, 280 

cornus, 154 

cotton-root, 268 

couchgrass, 376 

cubeb, 391 

cypripedium, 120 

dandelion, 376 

digitalis, 273 

dogwood, 154 



580 



INDEX. 



Fluid extract, dulcamara, 102 
ergot, 266 
erythroxylon, 123 
eucalyptus, 137 
eupatorium, 140 
frangula, 342 
gelsemium, 306 
gentian, 134 
geranium, 187 
ginger, 219 
glycyrrhiza, 535 
gossypium, 268 
grindelia, 309 
guarana, 128 
hamamelis, 188 
heartsease, 348 
Hydrastis, 259 
hyoscyamus, 97 
ipecac, 315 
iris, 348 
jaborandi, 360 
koosso, 559 
krameria, 184 
lactucarium, 84 
leptandra, 342 
lobelia, 296 
lupulin, 102 
matico, 392 
mezereon, 363 
nux vomica, 257 
pareira, 392 
pepo, 560 
pilocarpus, 360 
pipsissewa, 395 
podophyllum, 347 
prunus Virginiana, I 
pumpkin-seed, 560 
quassia, 133 
rhubarb, 336 
rhus glabra, 188 
rose, 188 
rubus, 189 
sanguinaria, 317 
sarsaparilla, 362 

compound, 362 
savine, 400 
Scutellaria, 121 
senega, 380 
senna, 341 
serpentaria, 137 
skullcap, 121 
spigelia, 553 
squill, 369 
stillingia, 365 
stramonium, 95 
sumac, 188 
taraxacum, 376 
triticum, 376 
uva ursi, 394 
valerian, 120 
veratrum viride, 236 



55 



Fluid extract, viburnum, 308 
wild cherry, 155 
witchhazel, 188 

extracts, 50, 56 

Ledoyen's disinfecting, 194 
Fluidounce, 60 
Fluidrachm, 60 
Fluigram, 60 
Fly, potato, 517 

Spanish, 513 
Foeniculum, 225 

vulgare, 225 
Fomentation, 39 
Fonticuli, 35 
Foreign leech, 34 
Formic acid, 283 

Forms in which medicines are used, 49 
Formyl, terchloride of, 102 

teriodide of, 431 
Fowler's solution, 446 
Foxglove, 268 
Frangula, 342 
Frangulin, 342 
Fraxin, 321 
Fraxinus ornus, 321 

rotundifolia, 321 
Freezing mixtures, 112 
Fresh herbs, tinctures of, 55 
Friction electricity, 41 
Frictions, 33, 35 
Frigus, 40 

Fumigation, mercurial, 409, 416, 422 
Fungi, 261, 266 
Fused silver nitrate, 201, 519 
diluted, 201, 519 
Fusel oil, 205, 300 



Gadida, 436 

Gaduin, 437 

Gadus Morrhua, 436 

Galbanum, 115, 399 

Gall-oak, 181 

Galla, 181 

Gallic acid, 180, 186 

Gallon, 60 

Galls, 181 

black, 182 

white, 182 
Galvanic electricity, 41 
Galvanism, 41 
Gal vano- cautery, 45 
Gamboge, 351 

cake, 351 

lump, 351 

Pipe, 351 
Garcinia Hanburii, 351 
Gargarismata, 66 
Gargles, 66 
Garlic, 381, 511 
Gas, nitrous-oxide, ill 



INDEX. 



581 



Gas, laughing, ill 
Gases, 50, 58 
Gaultheria, 220 

procumbens, 220 
Gaultherilene, 221 
Gelatin, 540 

capsules, 52 
Gelatinous magnesia, 444 
Gelsemine, 305 
Gelseminic acid, 305 
Gelsemium, 304 

sempervirens, 304 
General bloodletting, 33 
Gentian, 133 

yellow, 133 
Gentiana, 133 

lutea, 133 
Gentianaceas, 133, 135 
Gentianin, 133 
Gentiopicrin, 133 
Gentisin, 133 
Gentisic acid, 133 
Geraniaceae, 186 
Geranium, 186 

maculatum, 618 
German chamomile, 139 
Giant powder, 302 
Gill, 61 
Gin, 210 
Ginger, 219, 51 1 

black, 219 

Jamaica, 219 

white, 219 
Gingerol, 219 
Glauber's salt, 332 
Glonoin, 302 
Glyceric alcohol, 543 
Glyceril hydrate, 543 
Glycerin, 543 
Glycerinum, 543 
Glycerita, 56, 544 
Glycerite of borate of sodium, 473 

sodium borate, 473 

starch, 540, 544 

yolk of eggs, 544 
Glycerites, 50, 56, 544 
Glyceritum amyli, 540, 544 

vitelli, 544 
Glyceryl nitrate, 302 
Glycil hydrate, 543 
Glyconin, 544 
Glycyrrhetin, 535 
Glycyrrhiza, 534 

echinata, 534 

glabra, 534 

glandulifera, 535 
Glycyrrhizin, 535 
Glycyrrhizin, ammoniated, 535 
Glycyrrhizinum ammoniatum, 535 
Gnoscopine, 74 
Goa- powder, 524 



Gold and sodium chloride, 423 
Golden seal, 258 

Gondret's vesicating ointment, 518 
Gossypii radicis cortex, 267 
Gossypium, 268 

herbaceum, 267, 532 
Goulard's cerate, 193 

extract, 193 
Grains, 58, 59 
Gram, 59 

Graminaceae, 211, 260, 266, 376, 539, 548 
Granataceae, 557 
Granatum, 557 
Granulated effervescing salts, 51 

magnesium citrate, 331 
Granulation, 51 
Granville's lotion, 518 
Grape sugar, 547 , 548 
Gray powder, 409, 412 
Green iodide of mercury, 410, 420 

mercurial iodide, 410, 420 

soap, 523 

vitriol, 161 
Griffith's anti-hectic mixture, 161 
Grindelia, 308 

robusta, 308 
Grindelin, 308 
Ground flaxseed, 531 
Ground-holly, 394 
Guaiac, 362, 399 

wood, 362 

beta-resin, 362 
Guaiaci lignum, 362 

resina, 362 
Guaiacic acid, 362 
Guaiaconic acid, 362 
Guaiacum, 362 

officinale, 362 

sanctum, 362 

wood, 362 
Guaiaretic acid, 362 
Guarana, 128 

Guatemala sarsaparilla, 361 
Gum, 528 

ammoniac, 1 15 

arabic, 528 

Barbary, 528 

Bassora, 528 

India, 528 

Kordofan, 528 

pectoral, 530 

Senegal, 528 

tragacanth, 530 

Turkey, 528 
Gummic acid, 529 
Gun cotton, 545 
Gunjah, 99 
Guttiferae, 351 
Gutta-percha solution, 546 



582 



INDEX. 



Habit, influence of, on medicinal effects, 

63 
Hematics, 72, 403 
Hematein, 185 
Hematinics, 72, 403 
Haematomonas malariae, 148 
Hematoxylin, 185 
Haematoxylon, 185 

campechianum, 185 
Hamamelaceae, 187, 397 
Hamamelis, 187 

virginica, 187 
Hashish, 99 
Haw, black, 307 
Heartsease, 322 
Heat, 38, 39 
Heavy magnesia, 329 
Hectogram, 59 
Hedeoma, 225 

pulegioides, 225 
Hedeomol, 225 
Hellebore, American, 232 

swamp, 232 
Hemiptera, 550 
Hemlock, 278 

gum, 511 

spruce, 5 1 1 

pitch plaster, 511 
Hemp, American, 99 

Canadian, 374 

Indian, 99 
Henbane, 95 
Henry's magnesia, 329 
Hepatic aloes, 338 
Herapathite, 144 
Herapath's test, 144 
Hesperidin, 223 
Hippuric acid, 486 
Hircin, 541 
Hirudo decora, 34 

medicinalis, 34 
Hive-syrup, 369 
Hoffman's anodyne, 130 
Hog, 541 
Homatropine, 93 
Honduras sarsaparilla, 360 
Honey, 56, 320, 548 

bee, 542, 548 

clarified, 548 

of rose, 188 

of sodium borate, 473 
Honeys, 50, 56 
Hope's camphor mixture, 118 
Hops, 101 

Hordeum distichum, 211 
Horehound, 225 
Hot-air bath, 39 

bath, 39 

bottles, 39 

bricks, 39 

foot bath, 39 



Hot iron, 39 

vapor bath, 39 

water, 39 
Howard's calomel, 414 
Humulus, 1 01 

Lupulus, 1 01 
Husband's magnesia, 329 
Huxham's tincture, 137, 149 
Hydragogues, 319 

Hydrargyri chloridum corrosivum, 409, 
416, 468, 522 
mite, 354, 355. 4°9, 414, 47° 

cyanidum, 410, 421 

iodidum rubrum, 410, 420, 470 
viride, 410, 420 

oxidum flavum, 409, 413 
rubrum, 409, 412 

nitratis, unguentum, 410, 422 
liquor, 410, 423, 522 . 

prseparata, 404 

subsulphas flavus, 410, 421 

sulphidum rubrum, 410, 422 
Hydrargyrum ammoniatum, 410, 421 

cum creta, 409,412 
Hydrastine, 258 
Hydrastis, 258 

canadensis, 258 
Hydrate of chloral, 283 

croton-chloral, 286 

phenyl, 476 

potassa, 519 

propenyl, 543 
Hydrated oxide of iron, 160, 444 

with magnesia, 160, 444 
Hydride of phenyl, 474 
Hydrobromate of quinine, 15 1 
Hydrobromic acid, diluted, 291 
Hydrochinone, 475, 489 
Hydrochlorate of apomorphine, 317 

cocaine, 123 

morphine, 83 

pilocarpine, 360 

quinine, 151 
Hydrochloric acid, 172 

diluted, 172 
Hydrocotarnine, 74 
Hydrocyanic acid, 296, 299 

diluted, 296 
Hydroquinone, 475, 489 
Hydroxyl, 474 
Hygienic remedies, ^ 
Hymenoptera, 542 
Hyoscine, 96 

hydrochlorate, 98 
Hyoscyami folia, 95 
Hyoscyaminae sulphas, 97 
Hyoscyamine, 89, 96 

sulphate, 96, 97 
Hyoscyamus, 95 

leaves, 95 

niger, 95 



INDEX. 



583 



Hyphae, 261 

Hypnone, 87 * 

Hypnotics, 72 

Hypodermic application of medicines, 65 

Hypophosphite of calcium, 449 

iron, 165, 450 

potassium, 449 

sodium, 449 
Hypophosphites, 449 

syrup of, 449 

with iron, syrup of, 450 
Hyposulphite of sodium, 471 



Ice, 41 

bag, 40 
Iceland moss, 536 
Ichthyocolla, 540 
Idiosyncrasy, influence of, on medicinal 

effects, 63 
Igasuric acid, 252 
Igasurine, 252 
Ignatia, 257 
Ilex Paraguaiensis, 128 
Illicium, 226 

anisatum, 226 
Imagination, influence of, 63 
Imponderable remedies,^, 38 
Imported leech, 34 
Incompatibility, 50 
India gum, 528 

opium, 74 

senna, 340 
Indian corn, 266 

hemp, 99 

meal, 320 

poke, 232 

tobacco, 294 
Induced electricity, 41, 42 
Inee, 274 
Inflatin, 294 
Infusa, 53 
Infusion of apocynum, 375 

bray era, 559 

calamus, 220 

cascarilla, 141 

chamomile, 138 

cinchona, 149 

cypripedium, 120 

dandelion, 375 

digitalis, 273 

eupatorium, 140 

fennel, 225 

gaultheria, 222 

hops, 102 

koosso, 559 

lobelia, 296,. 

magnolia, 141 

prunus Virginiana, 155 

quassia, 133 

senna, compound, 341 



Infusion of serpentaria, 137 

tobacco, 294 

wild cherry, 155 
Infusions, 50, 53 
Infusum brayerae, 559 

cinchonas, 149 

digitalis, 273 

pruni Virginianae, 155 

sennas compositum, 341 
Ingluvin, 156 
Inhalation, 58 
Injection, 68 

intravenous, 69 
Inosit, 269 

Insecta, 513, 542, 550 
Insufflation, 66 
Intravenous injections, 69 
Inulin, 238, 376 
Iodide of ammonium, 430 

arsenic, 448 

and mercury, 448 

iron, 164, 431 

lead, 193, 43 1 

mercury, 410, 420, 431 

potassium, 428 

silver, 201 

sodium, 431 

starch, 43 1 

sulphur, 431 

zinc, 198, 431 
Iodine, 404, 424, 470 

ointment, 428 
Iodism, 425 
Iodized collodion, 546 

starch, 431, 540 
Iodo-cotton, 268 
Iodoform, 431 

cotton, 268 
Iodoformum, 431 
Iodol, 434 
Iodum, 424, 470 

Ioduretted potassium iodide, 428 
Ipecac, 312, 357 

black, 312 

gray, 312 

red, 312 
Ipecacuanha, 312 
Ipecacuanhic acid, 313 
Ipomcea turpethum, 421 
Iridaceae, 348, 550 
Iridin, 348 
Iris, 348 

versicolor, 348 
Irish moss, 537 
Iron, 157 

and ammonium citrate, 167 

acetate, mixture of, 164 
sulphate, 167 
tartrate, 167 
potassium tartrate, 164 
quinine citrate, 1.66 



584 



INDEX. 



Iron and quinine citrate, solution of, 167 

strychnine citrate, 167 
bitter wine of, 167 
bromide, syrup of, 166 
by hydrogen, 160 
carbonate, 160 

mass of, 161 

saccharated, 160 
chloride, 162 
citrate, 165 

solution of, 165 
compound pills of, 161 
dialyzed, 167, 444 
dried sulphate of, 162 
hydrate, 160, 444 

with magnesia, 160, 444 
hypophospbite, 165, 450 
iodide, pills of, 164 

saccharated, 164 

syrup, 164 
lactate, 166 

mixture, compound, 161 
nitrate, 162 

solution of, 165 
oxalate, 166 
oxide, 159, 160 
pills, compound, 1 61 
phosphate, 165 
pills of aloes and, 168, 339 

of iodide of, 164 
plaster, 161 

precipitated sulphate of, 162 
preparations of, 157, 399, 403 
pyrophosphate, 165 

syrup of, 165 
Quevenne's, 160 
quinine and strychnine phosphates, 

syrup of, 167 
reduced, 160 
saccharated carbonate, 160 

iodide, 164 
solution of acetate of, 163 

chloride of, 163 

citrate of, 165 

nitrate of, 165 

subsulphate of, 162 

tersulphate of, 162 
sulphate, 161 

dried, 162 

precipitated, 162 
syrup of bromide of, 166 

iodide of, 164 
tincture of acetate, 163 

chloride, 163 
troches, 1 61 
valerianate, 167 
wine of citrate of, 167 
with magnesia, hydrated oxide of, 
160 
Irritants, 72, 377, 506 
Isinglass, 540 



Issues, S3, 35 



Jaborandi, 357 
Jaborine, 358 
Jalap, 343 
Jalapa, 343 
Jamaica ginger, 219 

kino, 183 

sarsaparilla, 360 
James' powder, 244 
Jamestown weed, 94 
Japaconine, 228 
Japaconitine, 228 
Japan camphor, 1 16 
Japanese aconite, 227 
Jasmine, Carolina, 304 

yellow, 304 
Jateorrhiza Calumba, 134 
Jerusalem oak, 553 
Jervine, 232, 233 
Jesuit's powder, 147 
Jewell's calomel, 414 
Juglandaceae, 337 
Juglandic acid, 337 
Juglans, 337 

cinerea, 337 
Juglone, 337 
Juices, 50 
Jujube paste, 530 
Juniper, 376 
Juniperus, 376 

communis, 376 

Sabina, 400 

virginiana, 400 



Kairin, 476, 499 
Kamala, 559 
Kelp, 424, 459 
Kilogram, 59 
Kinic acid, 143 
Kino, 183 

red, 183 

tannic acid, 183 
Kinoiin, 183 
Kino vie acid, 143 
Kombe, 274 
Kosin, 558 
Koosso, 558 
Kordofan gum, 528 
Krameria, 184 

tomentosa, 184 

triandra, 184 
Kramero tannic acid, 184 



Labarraque's liquid, 468 
Labiatse, 120, 223 
Lac asafcetidae, 115 
sulphuris, 326 



INDEX. 



585 



Lactate of iron, 166 

Lactic acid, 174 

Lacto-phosphate of lime, syrup of, 448 

Lactosin, 380 

Lactuca virosa, 84 

elongata, 84 
Lactucarium, 84 

English, 84 

German, 84 
Lactucin, 84 
Ladies' slipper, 120 
Lady Webster pill, 339 
Lanthopine, 74 
Lard, 540 

benzoinated, 397, 541 

oil, 541 
Lartigue's pills, 372 (foot-note.) 
Laudamine, 74 
Laudanosine, 74 
Laudanum, 83 
Lanolin, 541 
Laughing-gas, ill 
Lauracese, 116, 216, 364 
Laurostearic ether, 542 
Lavements, 68 
Lavendula, 223 

vera, 223 
Lavender, 223 
Laxatives, 319, 320 
Lead acetate, 192 

arthralgy, 190 

carbonate, 194 

cerate of subacetate, 193 

colic, 190 

diacetate, 193 

iodide, 193 

ointment of, 193 

liniment of subacetate, 193 

nitrate, 194 

ointment of, carbonate, 194 
iodide, 193 

oxide, 194 

paralysis, 191 

plaster, 58 

poisoning, 190 

preparations of, 189 

solution of subacetate, 193 
diluted, 193 

sugar of, 192 

subacetate, cerate of, 193 
liniment of, 193 
solution of, 193 
diluted, 193 

sulphate, 190 

sulphide, 190 

sulpho-carbolate, 480 

water, 193 

white, 194 
Ledoy en's disinfecting fluid, 194 
Leeches, 34 
Leguminosse, 182, 183, 185, 275, 28] 



321, 323, 339, 377,387, 398, 5M, 
530, 534, 55o 
Lemon-juice, 250 

essence, 250 

oil, 250 

peel, 250 

rind, 250 

spirit, 250 

syrup, 250 



Lenitives, 525 
Leopard's-bane, 238 
Lepidolite, 461 
Leptandra, 341 

virginica, 341 
Leptandrin, 341 
Lethal alcohol, 542 
Lettuce-opium, 84 
Levant worm seed, 554 
Leyden jar, 41 
Licebane, 240 
Lichenes, 536 
Lichenin, 537 
Light, 38 

magnesia, 329, 444 
Lignum vitse, 362 
Liliaceae, 337, 367, 381 
Lima bark, 143 
Lime-juice, 250 
Lime chloride, 450 

chlorinated, 467 

liniment, 463 

solution, 462, 463 

sulphurated, 471 

syrup, 463 

water, 462, 463 
Limonis cortex, 250 

succus, 250 
Linaceae, 530 
Liniment, lime, 463 

of ammonia, 213, 510 
belladonna, 93 
calcium, 463 
camphor, 118 
cantharides, 516 
chloroform, no 
lead subacetate, 193 
mustard, compound, 509 
turpentine, 385 

soap, 118 

volatile, 213, 510 
Linimenta, 57 
Liniments, 50, 57 
Linimentum ammoniae, 213, 510 

belladonnse, 93 

calcis, 463 

camphorae, 1 18 

cantharidis, 516 

chloroformi, no 

plumbi subacetatis, 193 



586 



INDEX. 



Linimentum saponis, 118 

sinapis compositum, 509 
terebinthinse, 384 
Linseed oil, 325,531 
Linum, 530 

usitatissimum, 530 
Liquidambar orientalis, 397 
Liquids, 50, 52 
Liquor acidi arsenici, 447 

ammonii acetatis, 247 

arsenii et hydrargyri iodidi, 448 

calcis, 462, 463 

ferri acetatis, 166 
chloridi, 163 
citratis, 165 
et quininae citratis, 167 
nitratis, 165 
subsulphatis, 162 
tersulphatis, 162 

gutta-perchae, 546 

hydrargyri nitratis, 410, 423 

iodi compositus, 427 

magnesii citratis, 331 

pepsini, 156 

plumbi subacetatis, 193 
dilutus, 193 

potassae 456, 457 

potassii arsenitis, 446 
citratis, 247 

sodae, 459 

chloratae, 468 

sodii arseniatis, 447 
silicatis, 547 

zinci chloridi, 197 
Liquores, 52 
Liquorice, 534, 535 

powder, compound, 341 

root, 534 
Liquors, malt, 211 
Litharge, 194 

plaster, 58 
Lithii benzoas, 462 

bromidum, 291 

carbonas, 461 

citras, 461 

praeparata, 461 

salicylas, 492 
Lithium benzoate, 462 

bromide, 291 

carbonate, 461 

citrate, 461 

preparations, 461 

salicylate, 492 
Lithontriptics, 456 
Liver of sulphur, 326 
Lobelia, 294, 318 

inflata, 294 
Lobeliaceae, 294 
Lobelic acid, 294 
Lobeline, 294 
Local anaesthetics, 112 



Local bloodletting, 33, 34 

emetics, 310 
Loganiaceae, 251, 257, 304, 551 
Logwood, 185 
London paste, 520 
Long-leaved pine, 382 
Lotion, Granville's, 518 
Loxa bark, 143 
Lozenges, 50, 52 
Lugol's solution, 427 
Lump gamboge, 351 
Lunar caustic, 201, 519 
Lupulin, 1 01, 102 
Lupulinum, 1 01, 102 
Lupulite, 101 
Lux, 38 

Lycopodiaceae, 536 
Lycopodium, 536 

clavatum, 536 
Lytta vesicatoria, 513 



Mace, 217 
Maceration, 53 
Macis, 217 
Madeira wine, 210 
Magendie's solution, 84 
Magistery of bismuth, 201 
Magnesia, 329, 444, 462 

alba, 330 

calcined, 329 

Ellis's, 329 

heavy, 329 

Henry's, 329 

Husband's, 329 

ponderosa, 329 
Magnesian limestone, 330 
Magnesii carbonas, 330, 462 

citras granulatus, 331 

citratis, liquor, 331 

praeparata, 462 

sulphas, 330 

sulphis, 471 
Magnesite, 330 
Magnesium carbonate, 330, 462 

citrate, granulated, 331 
solution of, 331 

hydrate, 330 

preparations, 462 

sulphate, 330 

sulphite, 471 

sulpho-carbolate, 480 
Magnetic electricity, 41, 42 
Magnolia, 141 

acuminata, 141 

glauca, 141 

tripetala, 141 

umbrella, 141 
Magnoliaceae, 141, 226 
Magnolin, 141 
Maisch's table, 62 



INDEX. 



587 



Male fern, 556 

Mallotus philippinensis, 559 

Malt, 211 

extract of, 211 

liquors, 211 
Malvaceae, 267, 533 
Mammalia, 128, 541 
Mandrake, 345 
Manganese, 168 

oxide, 168 

preparations of, 168, 399 

sulphate, 168, 332 
Mangani oxidum nigrum, 168 

praeparata, 168 

sulphas, 168, 332 
Manna, 321 

cannulata, 321 

fat, 321 

in flakes, 321 

in sorts, 321 
Mannit, 321, 341 
Margaric acid, 543 
Marigold, 364 
Marjoram, 225 
Marrubium, 225 

vulgare, 225 
Marshmallow, 533 
Marsh's test for arsenic, 440 

antimony, 241 
Martial preparations, 157 
Mass, blue, 354, 355 

of copaiba, 389 

ferrous carbonate, 161 
mercury, 354, 355, 404, 405 
Massa copaibae, 389 

ferri carbonatis, 161 

hydrargyri, 355 
Massage, ^8, 45 

a friction, 45 
Mate, 128 

Materia Medica, definition of, 33, 47 
Matico, 392 
Matricaria, 139 

chamomilla, 139 
May-apple, 345 
Meadow-saffron, 369 

sweet, 489 
Measures and weights, 58 

apothecaries' 58, 60 

approximate, 61 

troy, 58 

wine, 60 
Mecca senna, 340 
Mechanical remedies, 33 
Mechano-therapy, 45 
Meconic acid, 74, 76 
Meconidine, 74 
Meconin, 74 
Medicated poultices, 447 

syrups, 56 

waters, 50, 53 



Medicines, classification of, 70 

definition of, 46 

internal, 47 

local, 47 
Mel, 548 

despumatum, 548 

rosae, 188 
Melaleuca cajuputi, 218 
Melanthaceae, 232, 236, 369 
Melia azedarach, 556 
Meliaceae, 556 
Mellita, 56 
Melted butter, 334 

Menispermaceae, 134, 135, 259, 364, 392 
Menispermine, 260 
Menispermum, 364 

canadense, 364 
Mentha piperita, 223 

viridis, 223 
Menthol, 223, 224 
Menthylene, 224 
Mercurial cathartics, 319, 354 

chloride, 354, 355 

corrosive, 409, 416, 468, 522 
mild, 354, 355, 409, 414, 558 

fever, 404 

fumigation, 409,416, 422 

injection, 409 

inunction, 409 

iodide, green, 409, 420 
red, 409, 420, 470 

mass, 409, 411 

ointment, 409, 411 

oleate, 409, 413 

oxide, red, 409, 412 
yellow, 409, 413 

plaster, 409, 411 

tremor, 404 
Mercurials, 319,400, 404 
Mercuric chloride, 409, 416, 468, 522 

cyanide, 410, 421 

iodide, 4ro, 420, 470 

nitrate, solution of, 460, 423, 522 

oxide, red, 409, 412 
yellow, 409, 413 

subsulphate, 319, 4io,*42i 

sulphide, 404, 410, 422 
Mercurous chloride, 354, 355, 409, 414, 
558 

iodide, 410, 420 

oxide, 414 

black, 414 
Mercury, ammoniated, 410, 421 

corrosive chloride of, 409, 416, 468, 
522 

cyanide, 410, 421 

fumigation with, 409, 416, 422 

green iodide, 410, 420 

injection of, 409, 419 

inunction with, 409 

iodide of, green, 410, 420 



588 



INDEX. 



Mercury, iodide of, red, 410, 420, 470 

mass of, 354, 355, 409, 410 

metallic, 404, 409 

mild chloride of, 354,355, 4°9> 4 J 4> 
558 

nitrate of, 410, 422 

ointment of, 404, 411 

ammoniated, 410, 421 
nitrate of, 410, 421 
red iodide, 410, 420 
oxide, 409, 412 
yellow oxide, 409, 413 

oleate of, 409, 413 

preparations, 404 

red oxide of, 409, 412 

iodide of, 410, 420, 470 

solution of nitrate of, 410, 423, 522 

subsulphate of, 319, 410, 421 

sulphide of, 404, 410, 422 

with chalk, 409, 412 

yellow oxide of, 409, 413 
subsulphate of, 319 
Metallic arsenic, 439 

mercury, 404, 409 
Meta-benzoic acid, 475 
Meta-oxyphenol, 475 
Meter, 59 

Methal alcohol, 542 
Methenyl choloride, 107 
Methyconine, 279 
Methylene bichloride, no 
Methyl ethylic ether, 1 1 1 

nonyl-ketone, 401 

salicylate, 221 
Methylic ether, in 
Methy-theobromine, 1 21 
Metrical system of weights, 59 

compared with troy weights, 60 
Mezereon, 363 
Mezereum, 363 
Mild acrid cathartics, 319, 335, 399 

chloride of mercury, 354, 355, 409, 
414, 558 
Milk of asafetida, 1 15 

of sulphur, 326 

sugar of, 548 
Milkweed, 374 
Milligram, 5g 
Mimo-tannic acid, 179 
Mindererus, spirit of, 247 
Mineral acids, 169, 523 

astringents, 178, 189 

emetics, 318 

oils, 545 

tonics, 131, 157 
Minims, 60 
Mint, 223 

camphor, 223, 224 
Mirbane, essence of, 482 
Mistura ammoniaci, 1 16 

amygdalae, 529 



Mistura asafcetidae, 1 15 

chloroformi, 1 10 

cretae, 464 

ferri composita, 161, 396 

et ammonii acetatis, 164 

glycyrrhizae composita, 536 

magnesiae et asafcetidae, 1 15 
Mistura potassii citratis, 247 

rhei et sodae, 336 
Misturae, 52 

Mitscherlich's test for phosphorus, 177 
Mixture, almond, 529 

ammoniac, 116 

asafcetida, 115 

Basham's, 164 

brown, 536 

chalk, 464 

chloroform, 1 10 

copaiba, Chapman's 389 (foot-note) 

Hope's camphor, 118 

neutral, 247 

of glycyrrhiza, compound, 536 

of iron and ammonium acetate, 164 

of iron compound, 161, 396 

of liquorice, compound, 536 

of magnesia and asafetida, 115 

of potassium citrate, 247 

of rhubarb and soda, 336 
Mixtures, 50, 52 
Moccasin plant, 120 
Modus operandi of medicines, 48 
Molasses, 320, 547 
Monobromated camphor, 119 
Monkshood, 227 
Monsel's solution, 162 
Montpelier scammony, 349 
Moonseed, Canada, 364 
Morphina, 74, 75 
Morphinae acetas, 83 

hydrochloras, 8^ 

sulphas, 83 
Morphine, 74, 75 

acetate, 83 

hydrochlorate, 83 

meconate, 74 

sulphate, 8^ 
Morrhuol, 437, 438, 439 
Mortar, 51 
Moschus, 128 

moschiferus, 128 
Moss, Iceland, 536 

Irish, 537 
Motor-depressants, 251, 278 

excitants, 251 
Moulded silver nitrate, 201 
Moxa, 39, 523 
Mucilage, 529 

of acacia, 529 

of cydonium, 534 

of gum arabic, 529 

of slippery elm, 532 



INDEX. 



589 



Mucilage, of sassafras pith, 533 

of tragacanth, 530 
Mucilago acaciae, 529 

cydonii, 534 

sassafras, 533 

tragacanth oe, 530 

ulmi, 532 
Mucous membranes ; application of medi- 
cines to, 65 
Muriatic acid, 172 

diluted, 172 
Musk, 128 

artificial, 129 

China, 129 

deer, 128 

Russia, 129 
Mustard, 318, 507 

black, 318, 507 

flour, 507 

paper, 509 

seed, 507 

whey, 509 

white, 318, 507 
Mycelium, 261 
Mydriatic alkaloids, 98 
Myrcia acris, 211 
Myriagram, 59 
Myristic ether, 542 
Myristica, 217 

fragrans, 217 
Myristicaceae, 217 
Myristicerie, 217 
Myristicol, 217 
Myronate of potassium, 508 
Myrosin, 508 
Myroxylon Pereirae, 398 

toluifera, 398 
Myrrh, 396 
Myrrha, 396 
Myrtaceae, 137, 183, 218 



Naphthaline, 475, 495 
Naphthol, 497 
Narceine, 74, 75 
Narcotics, 72 
Narcotine, 74, 75 
Natal oin, 338 
Natron, 459 
Nauseants, 310 
Nauseating diaphoretics, 357 
Nebulization of fluids, 66 
Neurotics, 72 
Neutral mixture, 247 
Nicotine, 292 
Nicotiana tabacum, 292 
Nicotianin, 292 
Nightshade, black, 102 

deadly, 88 

woody, 102 
Nitrate of cerium, 203 



Nitrate of glyceryl, 302 

lead, 194 

mercury, 410, 422 

potassium, 244 

silver, 198 

diluted, 201 
fused, 201 

sodium, 246 
Nitre, 244 

crude, 244 

cubic, 246 

papers, 246 

refined, 244 

sweet spirit of, 248 
Nitric acid, 171 

diluted, 171 
Nitrite of amyl, 300 

potassium, 303 
sodium, 303 
Nitro-benzine, 474, 482 
Nitroglycerin, 302 
Nitroglycerinum, 302 
Nitro- hydrochloric acid, 173 

diluted, 173 
Nitro-muriatic acid, 173 

diluted, 173 
Nitrous oxide gas, 1 1 1 

powders, 246 

papers, 246 
Nitroxyl, 474 
Normal quinine sulphate, 150 

ferric sulphate, 162 
Norway spruce, 510 
Nucin, 337 
Nutgall, 181 
Nutmeg, 217 
Nux vomica, 251 



Oak, Jerusalem, 553 

white, 185 
Oak- red, 185 
Oatmeal, 320 

Occupation, influence of, 63 
CEdema arsenicalis, 442, 446 
CEnanthic acid, 210 

ether, 210 
Officinal, definition of term, 47 
Oil cake, 532 

canon, 463, 531 

castor, 323 

cotton seed, 532 

cod- liver, 436 

phosphorated, 439 

croton, 353, 518 

ethereal, 130 

flaxseed, 325, 531 

fusel, 205, 300 

lard, 541 

linseed, 325, 531 

olive, 223 



59Q 



INDEX. 



Oil phosphorated, 178 

of almond, expressed, 323 
amber, 129 
allspice, 218 
anise, 225 
benne, 533 
bitter almond, 299 
cajeput, 218 
camphor, 117 
Canada erigeron, 373 
carraway, 226 
cardamom, 220 
caryophyllus, 218 
chenopodium, 553 
cinnamon, 217 
cloves, 218 
copaiba, 387, 389 
coriander, 226 
cubeb, 390 
cypripedium, 120 
erigeron, 373 
eucalyptus, 138 
fennel, 225 
flaxseed, 325, 531 
garlic, 381 
gaultheria, 221, 489 
ginger, 219 
hedeoma, 225 
illicium, 226 
juniper, 376 
lavender, 223 

flowers, 223 
lemon, 250 
linseed, 325, 531 
mace, 218 
marjoram, 225 
mustard, volatile, 508, 509 
neroli, 223 
nutmeg, 218 
orange flowers, 223 

peel, 223 
pennyroyal, 225 
peppermint, 224 

Chinese, 224 
pimenta, 218 
rosemary, 224 
rue, 401 

sandal -wood, 391 
santal, 391 
sassafras, 364 
savine, 400 
spearmint, 224 
tansy, 401, 402 
tar, 385 

theobroma, 122,542 
thyme, 225, 505 
tobacco, 292, 294 
turpentine, 382, 384, 510, 558 
valerian, 120 
vitriol, 169 
wine, 130 



Oil of wormseed, 553 
phosphorated, 178 
sweet, 323 
Oils, distilled, 214 
essential, 214 
mineral, 545 
volatile, 214 
Ointment, 57, 541 

alkaline sulphur, 326 
basilicon, 387 
benzoinated/541 
blue, 409, 411 
citrine, 410, 422 
diachylon, 194 
Gondret's vesicating, 518 
sulphur, 326 

of ammoniated mercury, 410, 421 
antimony, 518 
belladonna, 93 
carbolic acid, 480 
carbonate of lead, 194 
chrysarobin, 525 
gallic acid, 181 
galls, 182 
iodide of lead, 193 

potassium, 430 
sulphur, 430 
iodine, 428 
iodoform, 432 
lead carbonate, 194 

iodide, 193 
mercuric nitrate, 410, 422 
oxide, red, 409, 413 
yellow, 409, 413 
mercury, 409, 411 
mezereon, 364 
nitrate of mercury, 410, 422 
nutgall, 182 
oxide of zinc, 197 
potassium iodide, 430 
red mercuric oxide, 409, 413 

oxide of mercury, 409, 413 
precipitate, 409, 413 
rosewater, 188 
stramonium, 95 
sulphur, 326 

iodide, 430 
sulphurated potassa, 326 
tannic acid, 180 
tansy, 401 
tar, 386 
tobacco, 254 
veratrine, 237 

yellow mercuric oxide, 409, 413 
oxide of mercury, 409, 413 
precipitate, 409, 413 
zinc oxide, 197 
Ointments, 50, 57 
Olea Europcea, 323 

volatilia, 214 
Oleaceae, 321, 323 



INDEX. 



591 



Oleata, 57 

Oleate of mercury, 409, 413 

veratrine, 237 
Oleates, 50, 57 
Oleatum hydrargyri, 409, 413 

veratrinae, 237 
Oleic acid, 542 
Olein, 532, 541 
Oleoresin of aspidium, 557 

black pepper, 216 

capsicum, 216, 510 

cubeb, 390 

cypripedium, 120 

filix mas, 557 

ginger, 219 
Oleoresin, lupulin, 102 

male fern, 557 
Oleoresina aspidii, 557 

capsici, 216, 510 

cubebse, 390 

lupulini, 102 

piperis, 216 

zingiberis, 219 
Oleoresinae, 56, 367 
Oleoresins, 50, 56 
Oleum adipis, 541 

aefhereum, 130 

amygdalae amarae, 299 
expressum, 323 

anisi, 226 

aurantii corticis, 223 
florum, 223 

cajuputi, 218 

cari, 226 

caryopbylli, 218 

chenopodii, 553 

cinnamomi, 217 

copaibae, 387, 389 

coriandri, 226 

cubebse, 390 

erigerontis, 373 

eucalypti, 138 

fceniculi, 225 

gaultheriae, 221 

gossypii seminis, 532 

hedeomae, 225 

juniperi, 376 

lavandulse, 223 
florum, 223 

limonis, 250 

Hni, 531 

menthae piperitae, 224 

viridis, 224 

morrhuae, 436 

myristicae, 218 

olivae, 323 

phosphoratum, 178 

picis liquidae, 385 

pimentae, 218 

ricini, 323 

rosmarini, 224 



Oleum rutae, 401 
sabinae, 400 
santali, 391 
sassafras, 364 
sesami, 533 

sinapis, volatile, 508, 509 
succini, 129 

terebinthinae, 384, 510, 558 
theobromae, 122, 542 
thymi, 225, 505 

tiglii, 353, 5i8 

Valerianae, 120 
Olive oil, 323 

tree, 323 
Ophelia chirata, 135 
Ophelic acid, 136 
Opii pulvis, 82 
Opium, 73 

denarcotisatum, 82 

plaster, 82 

powder, 82 
Orange flower, 223 
water, 223 

peel, 223 
Orchidaceae, 120, 226 
Ordeal bean, 281 
Origanum, 225 

vulgare, 225 
Ortho-benzoic acid, 475 
Ortho-oxyphenol, 475 
Ounce, 58, 59 
Ovis aries, 541 
Oxalate of cerium, 202 

iron, 166 
Oxide of allyl, 381 

antimony, 241 

arsenic, 439 

ethyls, 103 

iron, hydrated, 160 

with magnesia, 160 

lead, 194 

manganese, 168 

silver, 201 

zinc, 197 
Oxynarcotine, 74 



Pack, cold, 40 
Painter's colic, 190 
Pale rose, 188 
Palas, kino, 183 
Palma Christi, 323 
Palmitin, 324, 532 
Pancreatin, 156 

saccharated, 156 
Pancreatinum, 156 
Pansy, 322 
Papain, 157 
Pa paver, 73 

somniferum, 73 
Papaveraceae, 73, 315, 3+7 



592 



INDEX. 



Papaverine, 74, 76 
Papaya, 157 
Papayacese, 157 
Paper of cantharides, 517 

mustard, 509 

potassium nitrate, 246 
Papers, 50, 52 
Para-benzoic acid, 475 
Paraguay tea, 128 
Paraffme, 545 
Paraldehyd, 85 
Paramenispermin, 260 
Paramorphine, 74, 76 
Para- oxy phenol, 475 
Paregoric elixir, 83 
Pareira, 392 

brava, 392 
Paricine, 143 
Parillin, 361 
Parsley camphor, 402 
Partridge-berry, 220 

Parts to which medicines are applied, 64 
Pasque-flower, 237 
Paste, Jujube, 530 

London, 520 

Vienna, 520 
Paullinia, sorbilis, 128 
Pay tine, 143 
Peach, 320 
Pearlash, 457 
Pearl white, 201 
Pectin, 269 
Pedeliaceae, 533 
Pelletierine, 557 

tannate, 558 
Pelosine, 392 
Pennyroyal, 225 
Pepo, 559 
Pepper, black, 216 

cayenne, 215 

red, 215 

white, 216 
Peppermint, 223 

water, 224 
Pepsin, 155 
Pepsinum, 155 

saccharatum, 155, 156 
Percolation, 53 
Percolator, 53 

Permanganate of potassium, 169, 399, 466 
Persian opium, 74 
Pestle, 51 
Petrissage, 45 
Petrolatum, 57, 545 
Petroleum oils, 545 

ointment, 545 
Petroselinum sativum, 402 
Phaeoretin, 336 

Pharmaceutical modifications, 49 
Pharmacological remedies, 33, 46 
Pharmacology, 46 



Pharmacopoeia, 47 
Pharmacy, definition of, 47 
Phenic acid, 476 
Phenol, 474, 476 

cymylic, 505 
Phenyl, 474 

derivatives, 473 

hydrate, 476 

hydride, 474, 476 

methylacetone, 87 
Phlebotomy, 33 
Phlox Carolina, 551 
Phormine, 74 
Phosphate of ammonium, 452 

calcium, 448 

iron, 165 

quinine, 151 

sodium, 332 
Phosphide of zinc, 178 
Phosphorated cod-liver oil, 439 

oil, 178 
Phosphoric acid, 174 

diluted, 174 
Phosphorus, 175 
Physeter macrocephalus, 541 
Physiological antidotism, 49 
Physostigma, 281 

venenosum, 281 
Physostigminse salicylas, 283 
Physostigmine, 281 

salicylate, 283 
Phytolacca, 239 

berries, 239 

decandra, 239 

root, 229 
Phytolaccaceae, 239 
Phytolacca bacca, 239 

radix, 239 
Phytolaccin, 239 
Picraconitine, 227 
Picrsena excel sa, 132 
Picropodophyllin, 346 
Picrosclerotin, 263 
Picrotoxin, 260 
Picrotoxinum, 260 
Pill of iron carbonate, 161 

machine, 51 

tile, 51 
Pills, 50, 51 

blue, 354, 355 

compound cathartic, 352 

compressed, 52 

Lady Webster, 339 

Lartigue's gout, 372 (foot-note) 

of aloes, 339 

and asafetida, 115, 339 
and iron, 168, 339, 396 
and mastic, 339 
and myrrh, 339 
antimony, compound, 243 
asafetida, 115 



INDEX. 



593 



Pills of ferrous iodide, 164 

galbanum, compound, 115, 396 

iodide of iron, 164 

iron, compound, 161, 396 

iodide, 164 
opium, 82 
phosphorus, 178 
rhubarb, 337 
compound, 337 
Plummer's, 243 
Rufus's, 339 
sugar-coated, 52 
Pilocarpene, 358 
Pilocarpinae hydrochloras, 360 
Pilocarpine, 356 

hydrochlorate, 360 
Pilocarpus, 357 

pennatifolius, 357 
Pilulse, 51 

aloes, 339 

et asafcetidae, 115, 339 
et ferri, r68, 339 
et mastiches, 339 
et myrrhae, 339, 396 
antimonii compositae, 243 
asafoetidae, 115 
catharticae compositae, 352 
ferri compositae, 161, 196 

iodidi, 164 
galbani compositae, 115, 396 
opii, 82 

phosphor i, 178 
rhei, 337 

compositae, 337 
Pimenta, 218 
Pimpinella anisum, 226 
Pine, long leaved, 382 
pitch, 382 
yellow, 382 
Pinitus succinifer, 129 
Pinkroot, 551 
Pint, 60 

Pinus australis, 382 
palustris, 385 
taeda, 382 
Pipe gamboge, 351 
Piper, 216 

nigrum, 216 
Piperaceae, 216, 389, 392 
Piperina, 216 
Piperine, 216 
Pipsissewa, 394 

spotted, 394 
Pisces, 436, 540 
Pistachia, terebinthus, 383 
Pitch pine, 382 

plaster with cantharides, 51 1 
Pix Burgundica, 510 
Canadensis, "5 1 1 
liquida, 385 
Plasma, 540 

38 



Plasmodium malariae, 148 
Plaster, adhesive, 387 
court, 540 
of ammoniac, 116 

ammoniac with mercury, 1 16, 409, 

412 
arnica, 238 
asafetida, 1 1 5 
belladonna, 93 
Burgundy pitch, 511 
Canada pitch, 511 
capsicum, 216, 510 
galbanum, 115, 511 
hemlock pitch, 511 
iron, 161, 511 
lead, 58, 194 
litharge, 58, 194 
mercury, 404, 411 
opium, 82, 511 
pitch with cantharides, 511 
resin, 387 
soap, 194 
spice, 512 
sticking, 387 
warming, 511 
Plasters, 50 
Plumbi acetas, 192 
carbonas, 194 
iodidum, 193 
nitras, 194 
oxidum, 194 
praeparata, 189 
subacetatis, liquor, 193 
Plummer's pills, 243 
Pneumatic aspiration, 36 
Podophyllin, 346 
Podophyllinic acid, 346 
Podophyilotoxin, 346, 347 
Podophyllum, 345 
peltatum, 345 
Poison-nut, 251 
Poison-oak, 259 
Poke-berries, 239 

root, 232, 239 
Polychroit, 550 
Polygala senega, 378 
Polygalaceae, 378 
Polygaleae, 184 
Polygalic acid, 379, 380 
Polygonaceae, 183, 335, 402 
Polygonic acid, 402 
Polygonum hydropiperoides, 402 
Pomatum, Dupuytren's, 438 
Pomegranate, 557 
Poppy, black, 73 

white, 73 
Porphyroxin, 74 
Port wine, 210 
Porter, 211 
Potassa 519 

alcoholic, 519 



594 



INDEX. 



Potassa, cum calce, 520 
hydrate, 519 
solution of, 456, 457 
sulphurata, 326 
with lime, 520 
Potassii acetas, 366 

bicarbonas, 456, 457 
bichromas, 454, 522 
bitartras, 334 
bromidum, 286 
carbonas, 456, 457 

pura, 456, 457 
chloras, 452 
citras, 247 
cyanidum, 299 
et sodii tartras, 334 
hypophosphis, 449 
iodidum, 428 
nitras, 244 

permanganas, 169, 399, 466 
prseparata, 456 
sulphas, 333 
sulphis, 471 
tartras, 334 
Potassio- tartrate of iron, 164 
Potassium acetate, 366 
alum, 203 

and sodium tartrate, 344 
bicarbonate, 456, 457 
bichromate, 454, 522 
bitartrate, 334 
bromide, 286 
carbolate, 480 
carbonate, 456, 457 
chlorate, 452 
chromate, 454 
citrate, 247 

mixture of, 247 

solution of, 247 
cyanide, 299 
hydrate, 519 
hypophosphite, 449 
iodide, 428 

ioduretted, 428 

ointment of, 430 
myronate, 508 
nitrate, 244 
nitrite, 303 

permanganate, 169, 399, 466 
preparations, 456 

effects of, 244 
sulphate, 333 

acid, 508 
sulphide, 326 
sulphite, 471 
sulpho- carbolate, 4^0 
tartrate, 334 
Potato, 102 
flies, 517 
spirit, 205, 300 
Poultices, 39, 58, 526 



Poultices, charcoal, 527 
medicated, 527 
yeast, 527 
Pound, 58, 59 
Powder, antimonial, 244 
aromatic, 220 
compound chalk, 464 
effervescing, 335 
glycyrrhiza, 341 
jalap, 344 
Dover's, 82, 315, 357 
gray, 409, 412 
James's, 244 
Jesuits', 147 
nitrous, 246 

of ipecac and opium, 82, 315, 357 
jalap, compound, 344 
morphine, compound, 84 
opium, 82 

rhubarb, compound, 337 
Tully's, 84 
Powders, 50 

Seidlitz, 250, 335, 460 
Precipitated calcium carbonate, 463 
phosphate, 448 
ferrous sulphate, 162 
sulphur, 326 
zinc carbonate, 197 
Precipitation, 51 
Preparations, martial, 157 
of ammonia, 211 
ammonium, 462 
antimony, 241, 357 
arsenic, 439 
bismuth, 201 
calcium, 462 
copper, 195 
iron, 157, 399, 403 
lead, 189 
lithium, 456 
magnesia, 462 
manganese, 168, 399 
mercury, 404 
potassium, 456 
silver, 201 
sodium, 458 
zinc, 196 
Prepared chalk, 464 
Pride of China, 556 
Proof spirit, 55, 2og 
Propenyl hydrate, 543 
Protopine, 74 
Prune, 320 
Prunum, 320 
Prunus serotina, 154 
Virginkna, 154 
Prussic acid, 296 
Pseudaconine, 227 
Pseudaconitine, 227 
Pseudojervine, 233 
I Pseudomorphine, 74 



INDEX. 



595 



Psychotria emetica, 313 

Pterocarpin, 550 

Pterocarpus erinaceus, 183 
marsupium, 183 
santalinus, 550 

Pulsatilla, 237 

Pulveres, 50 

Pulverization of fluids, 66 

Pulvis antimonialis, 244 
aromaticus, 220 
cretae compositus, 464 
effervescens compositus, 335 
glycyrrhizae compositus, 341 
ipecacuanha et opii, 82, 315 
jalapae Compositus, 344 
morphinae compositus, 84 
rhei compositus, 337 

Pumpkin, 559 
seed, 559 

Punica granatum, 557 

Purgatives, 319 

Purging cassia, 323 

Purified aloes, 339 

Purple foxglove, 269 

Pyridine, 475, 497 

Pyrocatechin, 183, 475 

Pyroligneous acid, 385, 480 

Pyrophosphate of iron, 165 
of sodium, 333 

Pyroxylin, 545 

Pyroxylinum, 545 



Quaker button, 251 

Quassia, 132 
amara, 133 

Quassin, 132, 133 

Queen's delight, 365 

Querci-tannic acid, 185 

Quercitrin, 183 

Quercus alba, 185 
infectoria, 1 81 
lusitanica, 181 

Quevenne's iron, 160 

Quicksilver, 404 

Quillaia, 380 

Saponaria, 380 

Quillaiac acid, 380 

Quinamine, 143 

Quince seed, 534 

Quinicine, 143 

Quinidinae sulphas, 152 

Quinidine, 143, 144 
commercial, 144 
sulphate, 144, 152 

Quinina, 143 

Quininae bisulphas, 151 
hydrobromas, 151 
hydrochloras, 15 1 
sulphas, 143, 150 
valerianas, 151 



Quinine, 143 

bisulphate, 151 
crude, 152 
carbolate, 151 
citrate, 15 1 
hydrobromate, 151 
hydrochlorate, 151 
iodosulphate, 144 
phosphate, 151 
salicylate, 15 1 
sulphate, 143 
sulphocarbolate, 151 
sulphovinate, 151 
valerianate, 151 

Quinocine, 476 

Quinoidin, 162 



Race, influence of, 63 

Rain-water, 527 

Raisin, 320 

Ranunculaceae, 135, 227, 237, 240, 258, 

273, 276 
Red bark, 142 

cedar, 400 

chromate of potash, 454 

iodide of mercury, 410, 420, 470 

mercurial iodide, 410, 420 
sulphide, 410, 422 

mercuric oxide, 409, 412 

oxide of mercury, 409, 412 

pepper, 215, 510 

precipitate, 409, 412 

ointment, 409, 413 

rose, 188 

saunders, 550 

sulphide of mercury, 410,422 

wine, 210 
Reduced iron, 160 
Refrigerant diaphoretics, 357 
Refrigerants, 226, 247, 366 
Reinsch's test for arsenious acid, 441 
Relations between sp. gr. and bulk of 

liquids, 59 
Remedies, definition of, 33 

division of, 33 

hygienic, 33 

imponderable, 33, 38 

mechanical, 33 

pharmacological, ^^, 46 
Resin, 382, 386 

cerate, 387 

of copaiba, 388, 389 
jalap, 344 
May apple, 347 
podophyllum, 347 
scammony, 350 

plaster, 387 
Resina, 386 

copaivae, 388, 389 

jalapae, 344 



59 6 



INDEX. 



Resina, podophylli, 347 

scammonii, 350 
Resolvents, 404 

Resorcin, 113, 115, 116, 475, 487 
Rhamnaceae, 342 
Rhamnus Frangula, 342 

purshiana, 342 
Rhatanic red, 184 
Rhatany, 184 
Rheotannic acid, 336 
Rheotome, 42 
Rheum, 335 

officinale, 335 
rhaponticum, 336 
Rheumic acid, 336 
Rhceadine, 74 
Rhubarb, 335 
Chinese, 335 
European, 335 
Russian, 335 
stick, 336 
Turkey, 335 
Rhus glabra, 188 

toxicodendron, 259 
Ricinic acid, 324 
Ricinine, 324 
Ricinolein, 324 
Ricinus communis, 323 
Rio Negro sarsaparilla, 360 
Risus sardonicus, 257 
Riverius, salt of, 247 
Rochelle salt, 334 
Rock candy, 547 
Roll sulphur, 325 
Rosa centifolia, 188 

gallica, 188 
Rosacese, 154, 188, 299, 380, 534, 558 
Rose, red, 188 
white, 188 
Rose-water, 188 
Rosemary, 224 
Rosin, 386 
Rosmarinus, 224 

officinalis, 224 
Rottlera, 559 
Rottlerin, 559 
Rubefacients, 204, 214, 506 
Rubiaceae, 121, 141,312 
Rubijervine, 232 
Rubus, 188 

Canadensis, 188 
trivialis, 188 
villosus, 188 
Rue, 401 
Rufus's pills, 339 

Rules for converting troy weight into 
grams, 60 
apothecaries' measure into cubic 
centimeters, 60 
Rum, 210 
bay, 211 



Ruminantia, 128, 541 
Russian musk, 129 

rhubarb, 335 
Ruta graveolens, 401 
Rutacese, 357, 393, 401 
Rye, 260 



Sabina, 400 

Saccharated ferrous carbonate, 160 
iodide. 164 

pancreatin, 156 

pepsin, 156 
Saccharin, 548 
Saccharum, 547 

lactis, 548 

officinarum, 547 

Saturni, 192 
Saffranin, 550 
Saffron, 550 
Sage, 225 

Sajous' pharyngeal atomizer, 67 
Sal ammoniac, 450 

diureticus, 366 

prunelle, 244 
Salicacese, 154 
Salicin, 154, 489 
Salicinum, 154 
Salicylate of lithium, 492 
methyl, 221 
physostigmine, 283 
quinine, 151 
sodium, 492 
Salicylated cotton, 268 
Salicylic acid, 322, 475, 489 
Salicylic-phenol- ether, 492 
Saline cathartics, 319, 327 

diuretics, 365 

refrigerants, 247, 366 
Salix, 154 

alba, 154 

Helix, 154 
Salkowski's test for carbolic acid, 477 
Salol, 492 
Salt, Epsom, 330 

Glauber's, 332 

Rochelle, 334 

of Riverius, 247 

of tartar, 457 
Saltpetre, 244 
Salve, Deshler's, 387 
Salvia, 225 

officinalis, 225 
Sandal wood, 391 
Sanguinaria, 315 

canadensis, 315 
Sanguinarine, 315 
Sanguisuga officinalis, 34 
Santal, 391, 550 
Santalaceae, 391 
Santalic acid, 550 



INDEX. 



597 



Santalum album, 391 

rubrum, 550 
Santonica, 554 
Santonin, 555 
Santoninate of sodium, 556 
Santoninum,555 
Sapindacese, 128 
Sapo viridis, 523 
Saponin, 341, 379, 380 
Sapotoxin, 380 

Sarothamnus scoparius, 275, 377 
Sarsaparilla, 360 

Brazilian, 360 

Guatemala, 361 

Honduras, 360 

Jamaica, 360 

Rio Negro, 360 

Vera Cruz, 360 
Sass' modification of the atomizer, 68 
Sassafras, 364 

medulla, 364, 533 

officinale, 364, 533 

pith, 364, 533 
Saunders, red, 550 
S a vine, 400 
Scammonin, 349 
Scammonium, 349 
Scammony, 349 

Montpellier, 349 

Virgin, 349 
Scarifications, 34, 35 
Scarificator, 35 
Scilla, 367, 382 
Scillain, 368 
Scillin, 368 
Scillipicrin, 368 
Scillitoxin, 368 
Sclererytherin, 263 
Sclerocrystallin, 263 
Scleroiodin, 263 
Scleromucin, 263 
Sclerotic acid, 261, 266 
Sclerotium, 260 
Scleroxanthin, 263 
Scoparin, 377 
Scoparius, 377 
Scrophulariaceae, 269, 341 
Scruple, 58, 59 
Scudamore's draught, 372 
Scutellaria, 120 

integrifolia, 1 21 

laterifolia, 120 

pilosa, 121 
Seaside grape, 183 
Season of gathering, influence of, on 

plants, 49 
Secale cereale, 260 
Sedatives, 72, 226 
Seidlitz powder, 251, 335, 460 
Semi-solids, 50, 57 
Senega, 378, 399 



Senega snakeroot, 378 
Senegal gum, 528 
Senegin, 379, 380 
Senna, 329 

Alexandria, 340 

India, 340 

Mecca, 340 

Tinnevelly, 340 

Tripoli, 340 
Sennacrol, 341 
Sennit, 341 

Serous membranes, application of medi- 
cine to, 59 
Serpentaria, 136 
Sesamum indicum, 533 
Setacea, 35 
Setons, 33, 35 
Sevum, 541 
Sex, influence of, on medicinal effects, 

63 
Sheep, 541 
Sherry wine, 210 
Siegele's atomizer, 68 
Signs and abbreviations, 56,1 
Silver fir, 510 

iodide, 201 

nitrate, 198 

diluted, 201 
moulded, 201 

oxide, 201 

preparations of, 198 
Simarubaceae, 132 
Simple bitters, 132 

syrup, 56 
Sinapine sulphate, 508 
Sinalbin, 508 
Sinapis, 318, 507 

alba, 318, 507 

nigra, 318, 507 
Sinapism, 509 
Sinnigrin, 508 

Skin, application of medicines to, 64 
Skullcap, 120 
Slippery elm, 532 

bark, 532 
Sloe, 307 
Smartweed, 402 
Smelling salts, 214 
Smilacese, 360 
Smilacin, 361 
Smilax officinalis, 360 

medica, 360 
Smyrna opium, 74 
Snakeroot, black, 276 

seneka, 378 

Virginia, 136 
Snowden's atomizer, 67 
Soap bark, 380 

green, 523 

liniment, 118 

plaster, 194 



59 8 



INDEX. 



Soap wort, 380 
Socalo'in, 338 
Socotrine aloes, 338 
Soda, 520 

caustic, 5 20 

chlorinated, solution of, 468 

solution of, 459 
Sodii acetas, 366 

arsenias, 447 

benzoas, 486 

bicarbonas, 460 
venalis, 460 

bisulphite, 470 

boras, 473 

bromidum, 291 

carbonas, 459 

exsiccata, 460 

chloras, 454 

hypophosphis, 449 

hyposulphis, 471 

iodidum, 431 

nitras, 246 

phosphas, 332 

praeparata, 458 

pyrophosphas, ^33 

salicylas, 492 

santonin as, 556 

sulphas, 332 

sulphis, 470 

sulpho-carbolas, 480 
Sodium acetate, 366 

and aluminium fluoride, 459 

arseniate, 447 

solution of, 447 

benzoate, 486 

bicarbonate, 460 

bisulphite, 470 

borate, 473 

bromide, 291 

carbonate, 459 
dried, 460 

carbolate, 480 

chlorate, 454 

hypophosphite, 449 

hyposulphite, 471 

iodide, 431 

nitrate, 246 

nitrite, 303 

phosphate, 332 

preparations, 458 

pyrophosphate, 333 

salicylate, 492 

santoninate, 556 

sulphate, 332 

sulphite, 470 

sulpho carbolate, 480 
Soil, influence of, on plants, 49 
Solanaceae, 88, 94, 95, 98, 102, 215, 292 
Solanine, 102 
Solanum Dulcamara, 102 

nigrum, 102 



Solanum tuberosum, 102 
Solids, 50 

Solubility, influence of, on medicines, 49 
Soluble glass, solution of, 547 
gun-cotton, 545 
tartar, 334 
Solution, Condy's, 467 
Dobell's, 68 
Donovan's, 448 
Fowler's, 446 

Labarraque's disinfecting, 468 
Lugol's, 427 
Magendie's, 84 
Monsel's, 162 
of ammonium acetate, 247 

arsenic and mercuric iodide, 448 
arsenic chloride, 447 
arsenious acid, 447 
chlorinated soda, 468 
gutta percha, 546 
iodine, compound, 427 
iron, acetate, 166 

and quinine citrate, 167 
chloride, 163 
citrate, 165 
nitrate, 165 
subsulphate, 162 
tersulphate, 162 
lead subacetate, 193 

diluted, 193 
lime, 462, 463 
magnesium citrate, 331 
mercuric nitrate, 410, 423, 522 
pepsin, 156 
potassa, 456, 457 
potassium arsenite, 446 

citrate, 247 
soda, 458 
sodium arseniate, 447 

silicate, 547 
soluble glass, 547 
zinc chloride, 197 
Solutions, 50, 52 
Soporifics, 72 
South American kino, 183 
Spanish fly, 513 
Sparteine, 275, 377 

sulphate, 276 
Spastics, 251 
Spearmint, 223 
water, 224 
Special diuretics, 367 
Spermaceti, 541 
cerate, 542 
whale, 541 
Sphacelinic acid, 262 
Spice plaster, 512 
Spiced syrup of rhubarb, 337 
Spigelia, 551 _ 

marilandica, 551 
Spinants, 72, 251 



INDEX. 



599 



Spiraea ulmaria, 484 

Spirit of ammonia, 213, 462 

aromatic, 213, 462 
anise, 226 
camphor, 118 
chloroform, 1 10 
cinnamon, 217 
ether, compound, 130 
gaultheria, 221 
juniper, 210, 377 

compound, 377 , 
lavender, 223 
lemon. 250 
Mindererus, 247 
myrcia, 211 
nitre, sweet, 248 
nitrous ether, 248 
nutmeg, 218 
orange, 223 
peppermint, 224 
spearmint, 224 
turpentine, 384 
proof, 55, 209 
Spirits, 50, 55 
Spiritus, 55 

aetheris compositus, 130 

nitrosi, 248 
ammoniae, 213, 462 

aromaticus, 213, 462 
anisi, 226 
aurantii, 223 
campboiae, 118 
chloroformi, no 
cinnamomi, 217 
frumenti, 210 
gaultheriae, 221 
juniperi, 210, 377 

compositus, 377 
lavandulae, 223 
limonis, 250 
menfhae piperitae, 224 

viridis, 224 
Mindereri, 247 
myrciae, 211 
myristicae, 218 
odoratus, 225 
sac char i, 210 
vini Gallici, 210 
Spongio-piline, 58 
Spotted pipsissewa, 394 
Spruce hemlock, 511 

Norway, 510 
Spurious Burgundy pitch, 511 
Squill, 318, 367, 382 
Squirting cucumber, 352 
St. Ignatius' bean, 257 
Staphisagria, 240 
Staphisain, 240 
Star anise, 226 
Starch, 538 
Static electricity, 41 



Stavesacre, 240 
Stearic acid, 543 

ether, 542 
Stearin, 541 
Sterculiaceae, 542 
Sternutatories, 66 
Stethal alcohol, 542 
Stick-rhubarb, 336 
Stilbene, 398 
Stillingia, 365 

sylvatica, 365 
Stimulants, 72, 204 

aromatic, 205, 214 

diffusible, 205 
Stimulating diaphoretics, 357 

diuretics, 399 
Styptic cotton, 162 
Stomach, influence of condition, 66 
Stomachics, 205 
Storacin, 397 
Storax, 397 
Stramonii folia, 94 

semen, 94 
Stramonium, 94 

leaves, 94, 95 

seed, 94, 95 
Stronger ether, 103 

water of ammonia, 212, 517 

white wine, 210 
Strophantin, 274 
Strophantus, 274 

hispidus, 274 
Strychnina, 252, 257 
Strychninae sulphas, 257 
Strychnine, 252, 257 
Strychnine sulphate, 257 
Strychnos nux vomica, 25 1 

Ignatii, 257 

toxifera, 306 
Sturgeon, 540 
Sturiones, 540 
Styptic collodion, 546 
Styraceae, 396 
Styrax, 397 

Benzoin, 396 
Styrol, 398 

Subacetate of lead, solution of, 193 
Subcarbonate of bismuth, 202 
Sublimated cotton, 268 
Sublimation, 51 
Sublimed sulphur, 325 
Submtrate of bismuth, 2CI 
Subsulphate of mercury, yellow, 319 
Succinic acid, 130, 348 
Succinum, 129 
Succus limonis, 250 
Sudorifics, 356 
Suet, 541 
Sugar, 547 

barley, 548 

beet root, 547 



6oo 



INDEX. 



Sugar cane, 547 

grape, 547 

of lead, 192 
milk, 548 

raw, 547 

refined, 547 
Sulphate of aluminium, 204 

and ammonium, 203 
potassium, 203 

atropine, 93 

berberine, 135 

cincbonine, 152 

cinchonidine, 152 

copper, 196, 318, 523 

iron, 161 

dried, 162 
precipitated, 162 
and ammonium, 167 

magnesium, 330 

manganese, 168, 332 

morphine, 8^ 

potassium, 333 

quinine, 144, 150 

quinidine, 152 

sodium, 332 

sinapine, 508 

sparteine, 276 

strychnine, 225 

zinc, 318 
Sulphide of ammonium, 471 

antimony, 243 

of calcium, 471 

of mercury, red, 410, 422 
Sulphides, 327, 471 
Sulphite of ammonium, 471 

calcium, 327, 471 

magnesium, 471 

potassium, 471 

sodium, 470 
Sulphites, 470, 471 
Sulphocarbolate of quinine, 151 

calcium, 480 

lead, 480 

magnesium, 480 

potassium, 480 

sodium, 480 
Sulphocarbolates, 480 
Sulphocarbolic acid, 480 
Sulphocyanide of allyl, 508 

acrinyl, 508 
Sulphovinate of quinine, 151 
Sulphur, 325 

crude, 325 

flowers of, 325 

iodide, 431 

lotum, 325 

praecipitatum, 326 

sublimatum, 325 

washed, 325 
Sulphuretted antimony, 243 

lime, 471 



Sulphuretted potassa, 326 
Sulphuric acid, 169 

aromatic, 170 
diluted, 170 
ether, 103 
Sulphuris iodidum, 431 
Sulphurous acid, 470 
Sumach, 188 
Sumatra camphor, 116 
Sumbul, 309 
Suppositoria, 57 
Suppositories, 50, 57, 68 
Suppurants, 506, 518 
Sus scrofa, 541 
Swamp dogwood, 133 

hellebore, 232 
Swedish movement cure, 46 
Sweet flag, 220 
oil, 323 

orange peel, 223 
spirit of nitre, 248 
tincture of rhubarb, 337 
Sydenham's laudanum, 83 
Syrup, 56 

Cox's hive, 369 
of acacia, 529 
almond, 300 
althaea, 533 
blackberry, 189 
calcium lactophosphate, 448 
citric acid, 250 
garlic, 382 
ginger, 219 
gum arabic, 529 
hypophosphites, 449 

with iron, 168, 450 
ipecac, 315 
iron bromide, 166 
iodide, 164 
pyrophosphate, 165 
quinine and strychnine phosphates, 

187 
krameria, 184 
lactucarium, 84 
lemon, 250 
lime, 463 
marshmallow, 533 
orange, 223 

flowers, 223 
poppies, 73 
prunus Virginiana, 155 
rhatany, 184 
rhubarb, ^^J 

aromatic, 337 
spiced, 337 
rose, 188 

sarsaparilla, compound, 361 
senega, 380 
senna, 341 
simple, 56 
squill, 369 



INDEX. 



60 1 



Syrup of squill, compound, 369, 380 

tar, 386 

tolu, 399 

wild cherry, 155 
Syrupi, 56 
Syrups, 50, 56 

medicated, 56 
Syrupus, 56 

acacias, 529 
acidi citrici, 250 
allii, 382 
altheas, 533 
amygdalae, 300 
aurantii, 223 

florum, 223 
calcis, 463 

lactophosphatis, 448 
ferri bromidi, 166 

iodidi, 164 

quininae et strychninas phospha- 
tum, 167 
hypophosphitum, 449 

cum ferro, 168, 450 
pyrophosphatis, 165 
ipecacuanhas, 315 
kramerias, 184 
lactucarii, 84 
limonis, 250 
picis liquidas, 386 
pruni Virginianas, 155 
rhei, 337 

aromaticus, 337 
rosas, 188 
rubi, 189 

sarsaparillae compositus, 361 
scillae, 369 

compositus, 369 
senegas, 380 
sennas, 341 
tolutanus, 399 
zingiberis, 219 
Systemic emetics, 310 



Tabacum, 292 

Table for converting c. c. into f 3 , 61 

apothecaries' weights and measures 
into gram weights, 62 

of decimal with troy weights, com- 
parative, 60 
Tablespoon, 61 
Tamarind, 320, 321 
Tamarindus, 321 

indica, 321 
Tanacetin, 401 
Tanacetum, 401 

vulgar e, 401 
Tannic acid, 178, 179, 185, 186 
Tansy, 401 
Tar, 385 
Tapotement, 45 



Taraxacerin, 376 
Taraxacin, 376 
Taraxacum, 375 

Dens leonis, 375 
Tartar, 250 

cream of, 250, 251, 334, 366 
crude, 332 
emetic, 241, 318 
salt of, 457 
soluble, 334 
Tartaric acid, 249 
Tartarized antimony, 241, 318 
Tartrate of antimony and potassium, 241 
iron and ammonium, 167 

and potassium, 164 
potassium, 334 

and sodium, 334 
Tea, 122 

Paraguay, 128 
worm, 553 
Teaberry, 220 
Teacup, 61 
Teaspoon, 61 
Teleostia, 436 
Temperament, influence of, on medicinal 

effects, 63 
Terebinth aceas, 259 
Terebinthina, 382 

canadensis, 382 
Ternstromiaceas, 121 
Terra japonica, 182 
Test for acacia, 529 

aconite, 227 

aconitine, 227 

antimony, 241 

arsenic, 439 

atropine, 89 

bismuth, 202 

carbolic acid, 477 

cinchouidine, 145 

cinchonine, 144 

colchicine, 370 

copper, 195 

corrosive sublimate, 417 

creasote, 481 

cyanohydric acid, 257 

digitalis, 271 

gallic acid, 181 

guaiac, 362 

hydrochloric acid, 172 

hydrocyanic acid, 296 

iodine, 424 

lead, 190 

mercury, 417 

morphine, 75 

nitric acid, 171 

opium, 75 

phosphorus, 177 

prussic acid, 296 

quinicine, 144 

quinidine, 144, 145 



602 



INDEX. 



Test for quinine, 144 

salicylic acid, 490 
silver, 198 
starch, 539 
strychnine, 252 
sulphuric acid, 170 
tannic acid, 179 
veratrine, 236 
zinc, 196 
Berzelius- Marsh, 441 
Herapath's, 144 
Marsh's, 241, 440 
Mitscherlich's, 177 
Plugge's, 477 
Reinsch's, 441 
Salkowski's, 477 
Thalleioquin, 144 
Trapp's, 236 
Tetanocannabine, 100 
Tetra-iodo-pyrol, 434 
Tetterwort, 347 
Thalleioquin, 144 
Thalline, 476, 500 
Thea, 121 

chinensis, 121 
Thebaine, 74, 76 
Thebolactic acid, 74 
Theine, 121 
Theobroma, 122 

cacao, 542 
Theobromine, 122, 543 
Therapeutics, definition of, 47 
Thornapple, 94 
Thoroughwort, 139 
Thymelaceas, 363 
Thymene, 225 
Thymol, 225, 505 
Thymus vulgaris, 225, 505 
Tiglinic acid, 353 
Time of administration influences action 

of remedies, 63 

Tinctura aconiti, 232 

aloes, 339 

aloes et myrrhae, 339 
arnicas florum, 238 

radicis, 238 
asafcetidae, 115 
aurantii amari, 223 

dulcis, 223 
belladonnas, 93 
benzoini, 397 

composita, 397 
bryonias, 345 
calendula?, 364 
calumbae, 135 
cannabis Indicae, 101 
cantharidis, 378 
capsici, 215, 510 
cardamomi, 220 

composita, 220 
catechu composita, 183 



Tinctura chirata, 136 
cimicifugae, 278 
cinchonas, 149 

composita, 149 
cinnamomi, 217 
colchici, 373 
conii, 280 
croci, 550 
cubebae, 391 
digitalis, 273 
ferri acetatis, 166 

chloridi, 163 
gallae, 182 
gelsemii, 306 
gentianae composita, 134 
guaiaci, 363 

ammoniata, 363 
humuli, 102 
hydrastis, 259 
hyoscyami, 97 
ignatias, 257 
iodi, 427 

ipecacuanhas et opii, 83, 315 
kino, 184 
krameriae, 184 
lavandulas composita, 223 
lobelias, 296 
matico, 392 
moschi, 129 
myrrhas, 396 
nucis vomicae, 257 
opii, 83 

camphorata, 83 

deodorata, S^ 
physostigmatis, 283 
quassias, 133 
rhei, 337 

aromatica, 337 

dulcis, 337 
sanguinarias, 317 
saponis viridis, 524 
scillae, 369 
serpentarias, 137 
stramonii, 95 
sumbul, 310 
tolutana, 399 
Valerianae, 120 

ammoniata, 120 
vanillas, 226 
veratri viridis, 236 
zingiberis, 219 
Tincturae, 54 

herbarum recentium, 55 
Tincture of aconite, 232 
aloes, 339 

and myrrh, 339 
American hellebore, 236 
arnica flowers, 238 

root, 238 
asafetida, 115 
belladonna, 93 



INDEX. 



603 



Tincture of benzoin, 397 

compound, 397, 399 
bitter orange peel, 223 
bloodroot, 317 
bryony, 345 
calabar bean, 283 
calendula, 364 
calumba, 135 
cannabis Indica, IOI 
cantharides, 378 
capsicum, 215, 510 
cardamom, 220 

compound, 220 
catechu, compound, 183 
chirata, 136 
chloride of iron, 163 
cimicifuga, 278 
cinchona, 149 

compound, 149 
cinnamon, 217 
colchicum, 373 
columbo, 135 
conium, 280 
crocus, 550 
cubeb, 391 
cypripedium, 120 
digitalis, 273 
ferric acetate, 166 

chloride, 163 
galls, 182 
gelsemium, 306 
gentian, compound, 134 
ginger, 219 
green soap, 523 
guaiac, 363 _ 

ammoniated, 363 
hops, 102 

Huxham's, 137, 149 
hydrastis, 259 
hyoscyamus, 97 
ignatia, 257 
Indian hemp, 101 
iodine, 427 

compound, 427 
ipecac and opium, 83, 315 
iron chloride, 163 
kamala, 559 
kino, 184 
krameria, 184 
lavender, compound, 223 
lobelia, 296 
matico, 392 
musk, 129 
myrrh, 396 
nutgall, 182 
nux vomica, 257 
opium, 83 

camphorated, 83 

deodorized, 83 
orange peel, 223 
physostigma, 283 



Tincture of quassia, 133 
rhatany, 184 
rhubarb, 337 

and aloes, 337 
and gentian, 337 
and senna, 337 
aromatic, 337 
sweet, 337 
rottlera, 559 
saffron, 550 
sanguinaria, 317 
serpentaria, 137 
squill, 369 
stillingia, 365 
stramonium, 95 
sumbul, 310 
sweet orange peel, 223 
tolu, 399 
valerian, 120 

ammoniated, 120 
vanilla, 226 
veratrum viride, 236 
yellow jasmine, 306 
Tinctures, 50, 54 
ammoniated, 54 
ethereal, 55 
of fresh herbs, 55 
Tinnevelly senna, 340 
Tobacco, 292, 318 

Indian, 294, 318 
Tolene, 398 

Tolerance to medicines in disease, 63 
narcotics in disease, 72 
established by habit, 63 
Tolu, balsam of, 398 
Tonics, 72, 131 

mineral, 131, 157 
vegetable, 131, 132 
Topical medicines, 72, 464 
Toxicodendric acid, 259 
Toxicodendron, Rhus, 259 
Tragacanth, 530 
Tragacantha, 530 
Tragacanthin, 530 
Transfusion of blood, 69 

Aveling's apparatus for, 69 
Trapp's test for veratrine, 236 
Treacle, 547 

Treatment of poisoning by acetic acid, 
250 
aconite, 229 
alcohol, 208 
antimony, 241 
arsenic, 444 
atropine, 91 
belladonna, 91 
boracic acid, 472 
boric acid, 472 
calabar bean, 282 
camphor, 117 
carbolic acid, 478 



604 



INDEX. 



Treatment of poisoning by chloral, 285 

colchicine, 372 

conium, 280 

copper, 195 

corrosive sublimate, 417 

creasote, 48 1 

cyanhydric acid, 298 

daturine, 95 

digitalis, 271 

duboisine, 98 

essence of merbane, 482 

gold salts, 423 

hydrochloric acid, 172 

hydrocyanic acid, 298 

hyoscine, 97 

hyoscyamine, 97 

hyoscyamus, 97 

iodine, 425 

iodoform, 432 

lead, 191 

mercury, 417 

mineral acid, 169 

morphine, 78 

nitric acid, 171 

nitro-benzine, 482 

nux vomica, 255 

opium, 78 

phosphoric acid, 173 

phosphorus, 176 

physostigma, 282 

potassium nitrate, 246 

prussic acid, 298 

silver, 199 

squill, 368 

stramonium, 95 

strangury from cantha- 
rides, 516 

strychnine, 255 

sulphuric acid, 170 

tartar emetic, 241 

tobacco, 293 

veratrine, 237 

veratrum viride, 235 

zinc, 196 
Tremor mercurialis, 404 
Trimethylamine, 437 
Trinitroglycerin, 302 
Tripoli senna, 340 
Triticin, 376 
Triticum, 376 
repens, 376 
vulgare, 376, 538 
Trituratio elaterini, 353 
Trituration of elaterin, 353 
Trituration es, 50 
Triturations, 51 
Troches, 52 

of ammonium chloride, 452 
bicarbonate of sodium, 460 
catechu, 183 
chalk, 464 



Troches, chlorate of potassium, 452 

cubeb, 391 

ginger, 219 

glycyrrhiza and opium, 82 

ipecac, 315 

iron, 161 

krameria, 184 

magnesia, 462 

morphine and ipecac, 84, 315 

peppermint, 224 

potassium chlorate, 453 

sodium bicarbonate, 460 
santoninate, 556 

tannic acid, 180 
Trochisci, 52 

acidi tannici, 180 

ammonii chloridi, 452 

catechu, 183 

cretae, 464 

cubebae, 391 

ferri, 161 

glycyrrhizae et opii, 82 

ipecacuanhas, 315 

kramerise, 184 

magnesiae, 462 

menthae piperitae, 224 

morphinae et ipecacuanhas, 84, 315 

potassii chloratis, 452 

sodii bicarbonatis, 460 
santoninatis, 556 

zingiberis, 219 
Tropic acid, 93 
Tropine amygdalate, 93 
Troy weight, 58 
Tully's powder, 84 
Turkey gum, 528 

opium. 74 

rhubarb, 335 
Turpentine, 382 

American, 382 

Bordeaux, 382 

Canada, 382, 383 

Chian, 382, 383 

Venice, 382 

white, 382, 383 
Turpeth mineral, 319, 410, 421 
Tutty, 197 



Ulcers, application of medicines to, 69 
Ulmus, 532 

fulva, 532 
Umbelliferae, 113, 1 15, 225, 278, 309 

402 
Umbelliferon, 113, 1 15 
Unguent a, 57 
Unguentum, 57, 540 
acidi carbolici, 480 
gallici, 181 
tannici, 180 
antimonii, 518 



INDEX. 



605 



Unguentum, aquae rosae, 188 
belladonnae, 93 
chrysarobini, 525 
diachyli, 194 
gallae, 182 
hydrargyri, 404, 411 

ammoniati, 410, 421 
nitratis, 410, 422 
oxidi flavi, 409, 413 
oxidi rubri, 409, 413 
iodi, 428 
iodoformi, 434 
mezerei, 364 
picis liquidae, 386 
plumbi carbonatis, 194 

iodidi, 193 
potassii iodidi, 430 
stramonii, 95 
sulphuris, 326 

alkalinum, 326 
veratrinae, 237 * 
zinci oxidi, 197 
Urethan, 87 
Urginea scilla, 367 
Ursone, 393 
Urticacese, 99, 101, 532 
Ustilago, 266 

maydis, 266 
Uva ursi, 393 



Valerian, 119 
Valeriana, 119 

officinalis, 119 
Valerianaceae, 1 19 
Valerianate of ammonium, 120 

elixir of, 120 (foot note) 

bismuth, 202 

caffeine, 122 

iron, 167 

quinine, 15 1 

zinc, 198 
Valerianic acid, 119, 308, 310, 353 
Vallet's ferruginous mass, 161 
Vanilla, 226 

planifolia, 226 
Vanillin, 226 
Vapor bath, 39 
Vapors, 50, 58 
Vaseline, 57, 545 
Vegetable acids, 248 

astringents, 178, 179 

emetics, 312 

tonics, 131, 132 
Veins, injections into, 69 

of medicines into, 69 
Venesection, 33 
Venice turpentine, 382 
Vera Cruz sarsaparilla, 360 
Veratrina, 233 
Veratrine, 233 



Veratroidine, 232, 233 
Veratrum album, 232 

viride, 232 
Vermicide, 551 
Vermifuge, 551 
Vermilion, 422 
Vesicants, 204, 506, 512 
Vesicating taffetas, 516 

ointment, Gondret's, 518 
Vesication, 3g 
Viburnin, 308 
Viburnum, 307 

prunifolium, 307 
Vienna paste, 520 
Vina, 56 
Vinegar, 250 

ofbloodroot, 317 
lobelia, 296 
opium, 83 
sanguinaria, 317 
squill, 369 
Vinegars, 50, 56 
Vinum, 209 

album, 210 

fortius, 210 

aloes, 339 

antimonii, 243 

aromaticum, 140, 224, 225 

colchici radicis, 373 
seminis, 373 

ergotae, 266 

ferri amarum, 167 
citratis, 167 

ipecacuanhse, 315 

opii, 83 

*hei,337 

rubrum, 210 
Viola tricolor, 322 
Violaceae, 322 
Virgin scammony, 349 
Virginia snakeroot, 136 

tobacco, 292 
Vitriol, blue, 196 

elixir of, 170 

green, 161 

oil of, 169 

white, 196 
Volatile alkali, 211 

liniment, 510 

oil of mustard, 508, 509 

oils, 214 
Voltaic electrical current, 42 

electricity, 41, 42 
Von Hebra's green soap, 523 



Wahoo, 348 
Warm bath, 39 
Warming plaster, 511 
Warner's gout cordial, 337 
Wash, black, 414 



6o6 



INDEX. 



Wash, yellow, 409, 413 
Washed sulphur, 325 
Water, 527 
bath, 39 

cold, 40 
hot, 39 
warm, 39 
carbonic acid, 528 
chlorine, 467 
cologne, 225 
distilled, 527 
lead, 193 
lime, 462, 463 
rain, 527 
snow, 527 
of ammonia, 213 

stronger, 212, 517 
anise, 225 
bitter almonds, 300 
camphor, 118 
cinnamon, 217 
creasote, 482 
fennel, 225 
orange flower, 223 
peppermint, 224 
rose, 188 
spearmint, 224 
Water-pepper, 402 
Waters, distilled, 53 

medicated, 53 
Watery extracts, 57 
Wax, 542 

Weights and measures, 58 
apothecaries', 60 
metrical, 59 
troy, 58 
Wet sheet, cold, 40 
Whale, spermaceti, 541 
Whiskey, 210 
White arsenic, 439 
ginger, 219 
lead, 194 
mustard, 318, 507 
oak, 185 
pepper, 216 
poppy, 74 

precipitate, 410, 421 
rose, 188 
turpentine, 382 
vitriol, 196 
wax, 542 
willow, 154 
wine, 210 

stronger, 210 
Wild cherry, 154 
lettuce, 84 
valerian, 119 
Willow, 154 
Wine, 209 

aromatic, 140, 224, 225 
Madeira, 210 



Wine, measure, 60 
of aloes, 339 
antimony, 243 
colchicum root, 373 

seed, 373 
ergot, 266 
ipecac, 315 
iron, bitter, 167 
citrate, 167 
opium, 8^ 
rhubarb, ^37 
port, 210 
red, 210 
sherry, 210 
white, 210 

stronger, 210 
Wineglass, 61 
Wine whey, 210 
Wines, 50, 56 
Wintergreen, 394 
Wistar's cough lozenges, 82 
Witch hazel, 187 
Wolfsbane, 227 
Woody nightshade, 102 
Woorali, 306 
Woorara, 306 
Woorari, 306 
Worm tea, 553 
Wormseed, American, 553 

Levant, 554 
Wormwood, 140 
Wounds, application of medicines to, 69 



Xanthopuccine, 258 



Yeast poultice, 527 
Yellow bark, 142 

chromate of potash, 454 

gentian, 133 

jasmine, 304 

mercurial subsulphate, 319, 410, 421 

mercuric oxide, 409, 413 

oxide of mercury, 409, 413 

parilla, 364 

pine, 382 

precipitate, 409, 413 

root, 258 

wash, 363 

wax, 542 
Young's scheme for doses, 61 



Zea mays, 266 
Zinc, acetate, 197 

bromide, 291 

carbonate, 196, 197 

chloride, 196, 198 
solution of, 197 

iodide, 198 



INDEX. 



607 



Zinc nitrate, 196 

oxide, 196, 197 

commercial, 197 
ointment of, 197 

phosphide, 178 

precipitated carbonate, i< 

preparations, 196 

sulphate, 196 

valerianate, 198 
Zinci acetas, 197 

bromidum, 291 

carbonas praecipitatus, 19 



Zinci chloridum, 198, 522 
iodidum, 198 
oxidum, 197 

venale, 197 
praeparata, 196 
phosphidum, 178 
sulphas, 196, 318 
valerianas, 198 

Zingiber, 219 

officinale, 219 

Zingiberaceae, 217,219 

Zygophyllacese, 362 



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A NEW TEXT-BOOK JUST PUBLISHED. 

DISEASES OF THE SKIN. 

BY T. MCCALL ANDERSON, M.D., 

Professor of Clinical Medicine in the University of Glasgow. 

ASSISTED BY 

Dr. James Christie, Sec'y London Epidemiological Society for Indian Ocean and East Africa; Mem, 
Medical Soc. of Bombay, etc. Dr. Hector C. Ca'meron, Surgeon and Lecturer to Western Infirmary, 
Glasgow; Surgeon to Glasgow Hospital for Children, etc. William Macewen, m.b., m.d., Lecturer on 
Systematic and Clinical Surgery, Royal Infirmary ; Surgeon to Royal Infirmary and Children's Hospital, 
Glasgow, etc. 

WITH COLORED PLATES AND NUMEROUS WOOD ENGRAVINGS. 

Octavo. 650 Pages. Cloth, $4.50 ; Leather, $5.50. 

A treatise on Diseases of the Skin, with reference to Diagnosis and Treatment, 

including an Analysis of 11,000 Consecutive Cases. Thoroughly illustrated by new and 
handsome wood engravings, and several colored and steel plates prepared, under the 
direction of the author, from special drawings by Dr. John Wilson. 

PARTICULARLY STRONG IN TREATMENT. 

J^° Special attention is given to the Differential Diagnosis of Skin Diseases and to the 
treatment. There are over 150 prescriptions, which will serve as hints to the physician 
in dealing with obstinate and chronic cases. 

There has been no complete treatise on Dermatology issued for several years ; Professor 
Anderson has, therefore, chosen an opportune time to publish his book. 



Illustrating one of the Diseases of the Hair {See Fig. b,page 7). 

For nearly twenty-five years Professor Anderson has been a general practitioner and a 
hospital physician, with unusual opportunities for the study of this class of diseases, though 
not a "specialist," as the term is understood. His experience is, therefore, of great 
value, and the physician will feel that, in consulting this work, he is reading the expe- 
riences of a man situated as himself — with the same difficulties of diagnosis and treatment, 
and who has surmounted them successfully. We believe this to be a valuable feature of 
the book that will be recognized at once ; for it is undoubtedly a fact that a work like 
the present contains much practical information and many hints not to be found else- 
where. Professor Anderson is particularly happy in illustrating the impor- 
tant relations subsisting between the general economy and its covering, and 
his ideas of pathology and therapeutics, including a consideration of all the general 
and local manifestations of the common diseases of the economy which are manifested 
upon the surface, will find many appreciative readers. 

Diseases of the hair receive full systematic treatment. 

" We welcome Dr. Anderson's work not only as a friend, but as a benefactor to the profession, because the author has 
stricken off mediaeval shackles of insuperable nomenclature and made crooked ways straight in the diagnosis and treatment of 
this hitherto but littie understood class of diseases. The chapter on Eczema is, alone, worth the price of the book." — Nashville 
Medical News. 

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? QUIZ-COMPENDS ? 

A SERIES OF PRACTICAL MANUALS FOR THE PHYSICIAN AND STUDENT. 

Compiled in accordance with the latest teachings of prominent lecturers: and the 

most popular Text-books. 

They form a most complete, practical and exhaustive set of manuals, containing information 
nowhere else collected in such a condensed, practical shape. Thoroughly up to the times in 
every respect, containing many new prescriptions and formulae, and over two hundred and thirty 
illustrations, many of which have been drawn and engraved specially for this series. The 
authors have had large experience as quiz-masters and attaches of colleges, with exceptional 
opportunities for noting the most recent advances and methods. The arrangement of the sub- 
jects, illustrations, types, etc., are all of the most approved form, and the size of the books is 
such that they may be easily carried in the pocket. They are constantly being revised, so as to 
include the latest and best teachings, and can be used by students of any college of medicine, 
dentistry or pharmacy. 

Bound in Cloth, each $1.00. Interleaved, for the Addition of Notes, $1.25. 

No. 1. Human Anatomy. Fourth Edition, including Visceral Anatomy, formerly 
published separately. Over 100 Illustrations. By Samuel O. L. Potter, m.a., m.d., 
late A. A. Surgeon U. S. Army. Professor of Practice, Cooper Med. College, San Francisco. 

Nos. 2 and 3. Practice of Medicine. Third Edition. By Daniel E. Hughes, m.d., 
Demonstrator of Clinical Medicine in Jefferson Med. College, Phila. In two parts. 

Part I. — Continued, Eruptive and Periodical Fevers, Diseases of the Stomach, Intestines, Peritoneum, 
Biliary Passages, Liver, Kidneys, etc. (including Tests for Urine), General Diseases, etc. 

Part II. — Diseases of the Respiratory System (including Physical Diagnosis), Circulatory System and Ner- 
vous System ; Diseases of the Blood, etc. 

*** These little books can be regarded as a full set of notes upon the Practice of Medicine, containing the 
Synonyms, Definitions, Causes, Symptoms, Prognosis, Diagnosis, Treatment, etc., of each disease, and including 
a number of prescriptions hitherto unpublished. 

No. 4. Physiology, including Embryology. Fourth Edition. By Albert P. Brubaker, 
M.d., Prof, of Physiology, Penn'a College of Dental Surgery ; Demonstrator of Physiology 
in Jefferson Med. College, Phila. Revised, Enlarged and Illustrated. 

No. 5. Obstetrics. Illustrated. Third Edition. For Physicians and Students. By 
Henry G. Landis, m.d., Prof, of Obstetrics and Diseases of Women, in Starling Medical 
College, Columbus. Revised Edition. New Illustrations. 

No. 6. Materia Medica, Therapeutics and Prescription Writing. Fifth Revised 
Edition. With especial Reference to the Physiological Action of Drugs, and a complete 
article on Prescription Writing. Based on the Last Revision (Sixth) of the U. S. Pharma- 
copoeia, and including many unofficinal remedies. By Samuel O. L. Potter, m.a., m.d., 
late A. A. Surg. U. S. Army ; Prof, of Practice, Cooper Med. College, San Francisco. 5th 
Edition. Improved and Enlarged, with Index. 

No. 7. Gynaecology. A Compend of Diseases of Women. By Henry Morrts, m.d., 
Demonstrator of Obstetrics, Jefferson Medical College, Philadelphia. In Press. 

No. 8. Diseases of the Eye and Refraction, including Treatment and Surgery. By L. 
Webster Fox, m.d., Chief Clinical Assistant Opthalmological Dept., Jefferson Medical 
College, etc., and Geo. M. Gould, a.b. 71 Illustrations, 39 Formulas. 2d Edition. 

No. 9. Surgery. Illustrated. Third Edition. Including Fractures, Wounds, Disloca- 
tions, Sprains, Amputations and other operations; Inflammation, Suppuration, Ulcers. 
Syphilis, Tumors, Shock, etc. Diseases of the Spine, Ear, Bladder, Testicles, Anus, and 
other Surgical Diseases. By Orville Horwitz, a.m., m.d., Demonstrator of Anatomy, 
Jefferson Medical College. Third Edition. Revised and Enlarged. 77 Formulae and 91 
Illustrations. 

No. 10. Chemistry. Inorganic and Organic. For Medical and Dental Students. By Henry 
Leffmann, m.d., Prof, of Chemistry in Penn'a College of Dental Surgery, Phila. 2d Ed. 

No. 11. Pharmacy. Based upon " Remington's Text- Book of Pharmacy." By F. E. 
' Stewart, m.d., ph.g., Quiz-Master at Philadelphia College of Pharmacy. Second Ed- 

Bound in Cloth, each $1.00. Interleaved, for the Addition of Notes, $1.25. 

g^ These books are constantly revised to keep up with the latest teachings and discoveries. 

P. BLAKISTON, SON & CO., 1012 Walnut Street, Philadelphia. 



New Series of Text-Books. 

FOR MEDICAL STUDENTS AND PHYSICIANS. 

Demi-Octavo. Price of each book, Cloth, $3.00 ; Leather, $3.50. 

The object held in view in the preparation of this Series was to make books that should be concise and 

practical, not burdened by useless theories and discussions, but containing all that is needed or necessary for 

the student and practitioner. No pains have been spared to bring them up to the times, and the very low 

price at which they have been published is an additional point in their favor. Full circular, descriptive of 

the Series, will be sent upon application. 

WALSHAM'S PRACTICAL SURGERY. A Manual for Students and Physicians. By Wm. J. 
Walsham, m.d., Asst. Surgeon to, and Demonstrator of Surgery in, St. Bartholomew's Hospital; Sur- 
geon to Metropolitan Free Hospital, London, etc. With 236 Illustrations. 656 pp. 

Cloth, $3.00; Leather, $3.50 

YEO'S MANUAL OF PHYSIOLOGY. Third Edition. A New Text-book for Students. By 
Gerald F. Yeo, m.d., f.r.c.s., Professor of Physiology in King's College, London. Over 301 Illus- 
trations and a Glossary. 758 pages. Cloth, $3.00; Leather, $3.50 

PARVIN'S-WINCKEL'S DISEASES OF WOMEN. A Treatise on the Diseases of Women. By 
Dr. F. Winckel, Professor of Gynaecology and Director of the Royal University Clinic for Women, in 
Munich. Translated from the German by Dr. J. H. Williamson, Resident Physician Allegheny Gen- 
eral Hospital, Allegheny, Penn'a, under the supervision of, and with an Introduction by, Theophilus 
Parvin, m.d., Professor of Obstetrics and Diseases of Women and Children in Jefferson Medical College. 
Illustrated by 117 fine Engravings on Wood, most of which are new. 674 pp. 

Cloth, $3.00; Leather, $3.50 

POTTER'S MATERIA MEDICA, PHARMACY AND THERAPEUTICS. A Handbook of 
Materia Medica, Pharmacy and Therapeutics, — including the Physiological Action of Drugs, Special 
Therapeutics of Diseases, Official and Extemporaneous Pharmacy, etc., etc. By Sam'l O. L. Potter, 
M.A., m.d., Professor of Practice, Cooper Medical College, San Francisco; Author of " Quiz Compends " 
of Anatomy and Materia Medica, etc. With 600 Prescriptions and an Appendix containing numerous 
Tables comprising doses, diagnosis, Latin terms, formulse for hypodermics, metric equivalents, specific 
gravities and volumes, and obstetric memoranda — together with Notes on temperature and the clinical 
thermometer, poisons, urinary examinations and patent medicines, etc. 830 pages. 

Cloth, $3.00; Leather, $3.50 

GALABIN'S MIDWIFERY. A Manual of Midwifery. By Alfred Lewis Galabin, m.a., m.d., 
Obstetric Physician and Lecturer on Midwifery and the Diseases of Women at Guy's Hospital, London; 
Examiner in Midwifery to the Conjoint Examining Board of England. 227 Illustrations. 753 pages. 

Cloth, #3.00; Leather, $3.50 

GOODHART AND STARR, DISEASES OF CHILDREN. By J. F. Goodhart, m.d., Physi- 
cian to the Evelina Hospital for Children; Assistant Physician to Guy's Hospital, London. American 
Edition. Revised and Edited by Louis Starr, m.d., Clinical Professor of Diseases of Children in 
the Hospital of the University of Pennsylvania, and Physician to the Children's Hospital, Phila. With 
many new Prescriptions and over 50 Formulae, conforming to the U. S. Pharmacopoeia, and Directions 
for making Artificial Human Milk, for the Artificial Digestion of Milk, etc. 738 pages. 

Cloth, $3.00; Leather, $3.50 

RICHTER'S ORGANIC CHEMISTRY. By Prof. Victor von Richter, University of Breslau. 
Authorized translation. First American, from the Fourth German Edition. By Edgar F. Smith, m.a., 
PH.D., Translator of Richter's Inorganic Chemistry; Prof, of Chemistry in Wittenberg College, Spring- 
field, Ohio; formerly in the Laboratories of the University of Pennsylvania; Member of the Chemical 
Societies of Berlin and Paris, of the Academy of Natural Sciences of Philadelphia, etc. Illustrated. 
710 pages. Cloth, $3.00; Leather, $3.50 

REESE'S MEDICAL JURISPRUDENCE AND TOXICOLOGY. By John J. Reese, m.d., 
Professor of Medical Jurisprudence and Toxicology in the University of Pennsylvania ; late President 
of the Medical Jurisprudence Society of Philadelphia; Physician to St. Joseph's Hospital; Member of. 
the College of Physicians of Phila. ; Corresponding Member of the New York Medico- Legal Society, etc. 
2d Edition. Revised and Enlarged. 654 pages. Cloth, $3.00; Leather, #3.50 

WARING'S PRACTICAL THERAPEUTICS. Fourth Edition. A Manual of Practical Thera- 
peutics, considered with reference to Articles of the Materia Medica. Containing, also, an Index of 
Diseases, with a list of the Medicines applicable as Remedies, and a full Index of the Medicines and 
Preparations noticed in the work. By Edward John Waring, m.d., f.r.c.p., f.l.s., etc. 4th 
Edition. Rewritten and Revised. Edited by Dudley W. Buxton, m.d., Asst. to the Prof, of Medicine 
at University College Hospital; Member of the Royal College of Physicians of London. 666 pages. 

Cloth, $3.00; Leather, $3.50 

*g* These books may be obtained from booksellers, or, upon receipt of price, any book will be sent, postage 
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JUST PUBLISHED. SECOND EDITION. 

HUMAN PHYSIOLOGY. 

By LAMDOIS and STIRLING. 

With nearly 600 Illustrations. 

SECOND AMERICAN, FROM THE FIFTH GERMAN EDITION. 

A Text-Book of Human Physiology, including Histology and Microscopical Anatomy, 
with special reference to the requirements of Practical Medicine. By 

Dr. L. Landois, Professor of Physiology and Director of the Physiological Institute, 
University of Greifswald. Translated from the Fifth' German Edition, with addi- 
tions by Wm. Stirling, m.d., Sc.d., Brackenburg, Professor of Physiology and 
Histology in Owen's College and Victoria University, Manchester; Examiner in 
the Honors' School of Science, University of Oxford, England. Second Edition, 
revised and enlarged. 583 Illustrations. 

"A BRIDGE BETWEEN PHYSIOLOGY AND PRACTICAL MEDICINE." 

One Volume. Royal Octavo. Cloth, $6.50 ; Leather, $7.50. 

From the Prefaces to the English Edition. 
The fact that Prof. Landois' book has passed through four large editions in the original since 1880, and 
that in barely six months' time a second edition of the English has been called for, shows that in some 
special way it has met a want. The characteristic which has thus commended the work will be found 
mainly to lie in its eminent practicability; and it is this consideration which has induced me to undertake the 
task of putting it into English. Landois' work, in fact, forms a Bridge between Physiology and the Practice 
of Medicine. It never loses sight of the fact that the student of to-day is the practicing physician of 
to-morrow. In the same way, the work offers to the busy physician in practice a ready means of refreshing 
his memory on the theoretical aspects of Medicine. He can pass backward from the examination of patho- 
logical phenomena to the normal processes, and, in the study of these, find new indications and new lights 
for the appreciation and treatment of the cases under consideration. With this object in view, all the 
methods of" investigation which may, to advantage, be used by the practitioner, are carefully and fully 
described. Many additions, and about one hundred illustrations, have been introduced into this second 
English edition, and the whole work carefully revised. 

PRESS NOTICES. 

" Most effectively aids the busy physician to trace from morbid phenomena back the course of divergence from 
healthy physical operations, and to gather in this way new lights and novel indications for the comprehension and treatment 
of the maladies with which he is called upon to cope." — American Journal of Medical Sciences. 

" I know of no book which is its equal in the applications to the needs of clinical medicine." — Prof. Harrison Allen, late 
Professor of Physiology , University of Pennsylvania. 

" We have no hesitation in saying that this is the work to which the Practitioner will turn whenever he desires light 
thrown upon the phenomena of a complicated or important case." — Edinburgh Medical Journal. 

" So great are the advantages offered by Prof. Landois' Text-Book, from the exhaustive and eminently practical 
manner in which the subject is treated, that it has passed through four large editions in the same number of years. . . . 
Dr. Stirling's annotations have materially added to the value of the work. Admirably adapted for the Practitioner. . . , 
With this Text-book at command, no Student could fail in his examination." — The Lancet. 

"One of the most practical works on Physiology ever written, forming a ' bridge ' between Physiology and Practical 
Medicine. . . . Its chief merits are its completeness and conciseness. . . . The additions by the Editor are able and judicious. 
. . . Excellently clear, attractive and succinct." — British Medical Journal. 

" The great subjects dealt with are treated in an admirably clear, terse, and happily illustrated manner." — Practitioner. 

" Unquestionably the most admirable exposition of the relations of Human Physiology to Practical Medicine ever laid 
before English readers " — Students' Journal. 

"As a work of reference, Landois and Stirling's Treatise ought to take the foremost place among the text- 
books in the English language. The wood-cuts are noticeable for their number and beauty." — Glasgow Medical Journal. 

" Landois' Physiology is, without question, the best text-book on the subject that has ever been written." 
— New York Medical Record. 

" The chapter on the Brain and Spinal Cord will be a rrost valuable one for the general reader, the translator's notes adding 
not a iictle to its importance. The sections on Sight and Hearing are exhaustive. . . . The Chemistry of the Urine is thoroughly 
considered. ... In its present form, the value of the original has been greatly increased. . . . The text is smooth, accurate, 
and unusually fiee from Germanisms ; in fact, it is good English." — New York Medical Journal. 

" It is not for the physiological student alone that Prof. Landois' book possesses great value, for it has been addressed 
To the practitioner of medicine as well, who will find here a direct application of physiological to pathological processes." 
Medical Bulletin. . " ■ „ ■ ■ 

P. BLAKISTON, SON & CO., Publishers, 1012 Walnut St., Philadelphia. 



JUST READY. A TEXT-BOOK OF 

DISEASES OF THE EYE. 

BY DR. EDOUARD MEYER, 

Prof, a V Ecole Pratique de la Faculte de Medecine de Paris ; Chevalier of the Legion of Honor, etc, 

AUTHORIZED TRANSLATION BY 

FREELAND FERGUS, M. B., Assistant Surgeon, Glasgow Eye Infirmary. 

COLORED PLATES PRINTED UNDER THE DIRECTION OF 

DR. RICHARD LIEBREICH, M. R. C. S., Author of the "Atlas of Ophthalmoscopy." 

WITH COLORED PLATES AND 267 ENGRAVINGS ON WOOD. 

Octavo. 650 Pages. Cloth, $4.50 ; Leather, $5.50. 

Synopsis of Contents. — Diagnosis and Treatment of Ocular Affections. Diseases of the Conjunc- 
tiva. Diseases of the Cornea and Sclerotic. Iris — Ciliary Body — Choroid. Glaucoma. Diseases of the 
Optic Nerve and Retina. Amblyopia and Amaurosis. Diseases of the Vitreous Body. Diseases of the 
Crystalline Lens. Refraction and Accommodation. The Muscles of the Eye. Diseases of the Eyelids. 
Diseases of the Lachrymal Passages. Diseases of the Orbit. Table of Dioptries. Index. 




Forming a complete systematic Manual of Ophthalmology. The translating 

and editing have been done with the assistance 
of the author. The illustrations, which will be 
found of great help in diagnosis, have been care- 
fully engraved ; the colored plates, being re- 
duced from Liebreich's Atlas of Ophthalmology 
and printed under the direction of Dr. Liebreich, 
are accurate and faithful representations of their 
subjects. 

Treatment and Diagnosis receive full share 
of attention. Refraction and accommodation 
occupy a section of over sixty pages, being 
handled in a practical, concise way that will 
commend itself specially to students and physi- 
cians who have given the subject but little attention. The chapters describing the 
subject of general diagnosis and the proper instruments to be used, are thorough 
and well illustrated. 

Dr. Swan M. Burnett, reviewing the book in The Archives of Ophthalmology, says : " The cause of its popularity is not 
far to seek. It is clear, concise, conservative and eminently practical." 

This book has gone through three French and four German Editions, 
has been translated into Italian, Spanish, Polish, Russian, Japanese — 
this, the English Edition, making the eighth language in which it has 
been published. 



Fig. 27.— Pterygium. 

(Attention is called to the help in diagnosis of a 
cut of this character. It is followed by three en- 
gravings showing the operation for Pterygium.) 



GOWERS' 

DISEASES OF THE NERVOUS SYSTEM. 

Complete in One Large Octavo Volume. 1360 Pages. 341 Illustrations, con- 
taining over 700 Figures. Price in Cloth, $6.50 ; in Leather, $7.50. 



A COMPLETE TEXT-BOOK. By William R. Gowers, m.d., Professor Clinical 
Medicine, University College, London, Physician to University College Hospital 
and to the National Hospital for Paralyzed and Epileptic, etc. 

Published by special arrangement with the author, and containing all the mate- 
rial in the two-volume English edition, with some corrections and additions. This is 
probably the most exhaustive book ever published on Nervous Diseases. The 
author's breadth of scope, systematic and interesting style, combine to make his 
work one of the most useful that has been published in any branch of medicine. 



" The work, therefore, while serving to initiate the general reader in the elements of that science, ranks higher 
than a mere text-book on the subject. The author's object has been, in our opinion, skillfully and successfully 
carried out, and a perusal and study of this will place the student and practitioner in possession of all the leading 
and essential facts necessary to investigate and treat diseases of the nervous system according to the most recent 
improvements of our knowledge at the present day." — British Medical Journal. 

" It may be said, without reserve, that this work is the most clear, concise and complete text-book upon diseases 
of the nervous system in any language. And when the large number of such works which has appeared in Ger- 
many, France and England within the past ten years is considered, this implies high praise." — American Journal 
Medical Science, June, 1888. 

" It would be invidious to praise one part more than another, where all is so good. Brevity and conciseness, 
combined with completeness and the most absolute clearness, are the characteristics of the work. Taken as a 
whole, it promises to be the most useful work on diseases of the nervous system which we possess." — Dublin 
Journal 0/ Medical Sciences. 

" The student and practitioner will find in it a true friend, guide and helper in his studies of the diseases of 
the nervous system. It is a most complete manual, presenting a thorough reflex of the present state of know- 
ledge of the diseases of the nervous system. The care and thought that have been bestowed on its production 
are evident on every page. In the presence of such ability, learning and originality, criticism can only take a 
favorable direction. The style and manner are accurate, studied and adequate — never diffuse. The illustrations 
call for special notice. They are numerous, new and original. No better manual on nervous diseases has been 
presented to the medical profession." — London Lancet. 

" From a small beginning a great work has gradually been evolved. Less than ten years ago Gowers put out 
a very modest little book on the ' Diagnosis of Diseases of the Spinal Cord,' which was soon followed by an 
equally modest treatise on ' Diseases of the Brain.' Two years ago the first half of this manual appeared, com- 
prising Diseases of the Spinal Cord and Nerves, and now this manual of Diseases of the entire Nervous System 
is placed before us. Gowers' manual is herewith recommended to the general and to the special student. It is 
not too detailed for the former, while for the specialist it is explicit enough as a first-class book of reference. It 
is, on the whole, an admirable treatise." — Journal of Nervous and Mental Diseases, New York, May, 1888. 

* * * « The contents is so vast as to make it impossible, in a review, to enumerate the subjects handled by 
the author, far less to attempt an analysis and discussion of the views held by him on the numerous problems 
with which he has to deal. We shall limit ourselves, therefore, almost entirely to a statement of the leading 
features of this manual, that characterize it as one of the very best published in any language. * * * What 
we admire, first, is the clearness of thought and language in the exposition, even in the most difficult portions 
of the subject. It is not every one who, being a master, is at the same time a skillful expounder, and knows 
how to elucidate, whilst condensing, his theme. Secondly, we find the evidence on every page of the book of 
the author's individual familiarity with the topics he is discussing. * * * Finally, we note the thorough mas- 
tery of the author of the most recent researches." — Brain, London, 1888. 

P. BLAKISTON, SON & CO., 

X»ixt>lisliers, 1013 Walnut Street, IPhiladelpIiia, I»a. 



PUBLISHED ANNUALLY. 



With Many Improvements for 1889. 

38th YEAR. 
The Physician's Visiting List. 



(LINDSAY & BLAKISTON'S.) 
CONTENTS. 



Almanac for 1889 and 1890. 

Table of Signs to be used in keeping accounts. 

Marshall Hall's Ready Method in Asphyxia. 

Poisons and Antidotes. 

The Metric or French Decimal System of 
Weights and Measures. 

Dose Table, revised and rewritten for 1888, by Ho- 
bart Amory Hare, m. d., Demonstrator of Thera- 
peutics, University of Pennsylvania. 

List of New Remedies for 1888, by same author. 

Aids to Diagnosis and Treatment of Diseases of 
the Eye, Dr. L. Webster Fox, Clinical Asst. Eye 
Dept. Jefferson Medical College Hospital, and G. 
M. Gould. 

Diagram Showing Eruption of Milk Teeth, Dr. 
Louis Starr, Prof, of Diseases of Children, Univer- 
sity Hospital, Philadelphia. 



Posological Table, Meadows. 

Disinfectants and Disinfecting. 

Examination of Urine, Dr. J. Daland, based upon 
Tyson's " Practical Examination of Urine." 5th 
Edition. 

Incompatibility, Prof. S. 0. L. Potter. 

A New Complete Table for Calculating the 
Period of Utero-Gestation. 

Sylvester's Method for Artificial Respiration. 

Diagram of the Chest. 

Blank Leaves, suitably ruled, for Visiting List , 
Monthly Memoranda; 'Addresses of Patients and 
others ; Addresses of Nurses, their references, etc. ; 
Accounts asked for ; Memoranda of Wants ; Obstet- 
ric and Vaccination Engagements; Record of Births 
and Deaths ; Cash Account, etc. 



A NUMBER OF IMPROVEMENTS and additions have been made to the 
reading 1 matter in the first part. This has been done, however, without increasing 
the number of pages. Great care has been taken in selecting the leather for the 
covers and in each detail of manufacture. 

SIZES AND PRICES. 

Tucks, pockets and Pencil, $i.oc 
" . " " 1.25 

" " " 1.50 

" '* " 2.00 



For 25 Patients weekly. 


50 


75 " 


100 



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3.00 



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50 

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INTERLEAVED EDITION. 

Interleaved, tucks and Pencil, 1.25 

1.50 
2 Vols f Jan. to June 1 

2 vols. jj ulytoDec .J 

PERPETUAL EDITION, without Dates. 

$gg~Can be com7nenced at any time, and used until full. Similar in style, con- 
tents and arrangement to the regular edition. 
No. 1. Containing space for over 1300 names, with blank page opposite each 

Visiting List page. Bound in Red Leather cover, with Pocket and Pencil, #1.25 
No. 2. Containing space for 2600 names, with blank page opposite each 

Visiting List page. Bound like No. 1, with Pocket and Pencil, . . . . 1.50 

These lists, without dates, are particularly useful to young physicians unable to 
estimate the number of patients they may have during the first years of Practice, and 
to physicians in localities where epidemics occur frequently. 

" For completeness, compactness, and simplicity of arrangement it is excelled by none ; n the market." — N. Y. 
Medical Record. 

" The book is convenient in form, not too bulky, and in every respect the very best Visiting List published."— 
Canada Medical and Surgical Journal. 

After all the trials made, there are none superior to it." — Gaillard's Medical Journal. 

„ » 1 bec ° me Standard." —Southern Clinic. 

„ |; e .2 ula r as tn e seasons comes this old favorite." — Michigan Medical News. 

,, ip 1S °i u ' te convenient for the pocket, and possesses every desirable quality." — Medical Herald. 

»X. he , most P°P} llarVisitin g List extant."— 5z^«/^ Medical and Surgical Journal. 

„ We . nav e used it for years, and do not hesitate to pronounce it equal, if not superior, to any." — Southern Clinic. 

" This Visiting List is too well known to require either description or commendation from us." — Cincinnati 
Medical News. 






JUST READY. 
THE SEVENTH REVISED AND ENLARGED EDITION 



OF 



ROBERTS' PRACTICE. 

THE THEORY AND PRACTICE OP MEDICINE. By F RED 
T. Roberts, m.d., k.r.c.p., Professor of Materia Medica and Therape^ 
tics at Un.vers.ty Hospital, Physician to Universe College Hosp.ta e 2 
Seventh Edition. Revised and Enlarged. One V0 .:J, 8V S S 
merou, I, us.rat.ons. cloth Binding, fc . so / Leather ' 6 50 

The present edition has been fully revised through on t » n A ■ 
arranged. While an endeavor has ZnZZe oZt^ZZlTl* "^ " ~ 
special attention has been given to the question, of t!. S " bjeC ' n P' date ln aI1 "s aspects, 
no,ce infant therapeutists or S^ch hTb^ SJS^T*" ^ 

rec^dTX^nteeXta :^ **** "T^ 

pnbhshers are in receipt of nun^s t^tZTT^ t "** " * TeX '- b °° k - The 

favorably of it, and below they ! I Z [ZZfZ^ Pf^ * h °° h > ^"Z 

-^i::z^:-;rz:j hi> "• *> - 4' > • <— « »• «-.- 

ril o™""" * "' "°' k th " "" '""*" "" - b — " ■ "»i-«- <- — - 

BY THE SAME AUTHOR. 
NOTES ON MATERIA MEDICA AND PHARMACY. 

ESPECIALLY ARRANGED FOR THE USE OF STUDENTS. 

16mo, Cloth, $2.00. 
by^rptblisWs B ° 0kSeIIerS ; ° r WiU be SCnt by if- P°^- on receipt of price 

P. Blaihston, Son & Co., ioi 2 Walnut Street, Philadelphia. 



"IT STANDS WITHOUT AN EQUAL AS THE MOST COMPLETE WORK ON PRACTICE IN 
THE ENGLISH LANGUAGE."— New York Medical Journal. 

FAGGE'S PRACTICE OF MEDICINE. 

Two Large Royal Octavo Volumes. Containing over 1900 Pages. 
PRICE, HANDSOMELY BOUND IN CLOTH, $8.00. 

The Principles and Practice of Medicine, 

By CHARLES HILTON FAGGE, M.D., F.R.C.P., F.R.M.C.S., 

Examiner in Medicine, University of London ; Physician to, and Lecturer on Pathology in, Guy' s Hospital; 
Senior Physician to Evelina Hospital /or Sick Children, etc. 

EDITED AND ARRANGED FOR THE PRESS 

By P. H. Pye-Smith, M.D., F.R.C.P., 

Lecturer on Medicine in Guy's Hospital, London, etc., 

WITH A SECTION ON CUTANEOUS AFFECTIONS, BY THE EDITOR, A CHAPTER ON CAR- 
DIAC DISEASES, BY SAMUEL WlLKES, M. D., F. R. S., AND TWO INDEXES, ONE OF 
AUTHORS AND ONE OF SUBJECTS, BY ROBERT EDMUND CARRINGTON. 

Two Volumes. Royal Octavo. 1900 Pages. 

Price in Cloth, $8.00. Full Leather, $10.00. Half Morocco, $12.00. Half Russia, $12.00. 



It is based on laborious researches into the pathological and clinical records of 
Guy's Hospital, London, during the twenty years in which the author has held office 
there as Medical Registrar, as Pathologist, and as Physician. Familiar beyond most, 
if not all, of his contemporaries, with modern medical literature, a diligent reader of 
French and German periodicals, Dr. Fagge, with his remarkably retentive memory and 
methodical habits, was able to bring to his work of collection and criticism almost 
unequaled opportunities of extensive experience in the wards and dead house. The 
result is that which will probably be admitted to be a fuller, more original, and more 
elaborate text-book on medicine than has yet appeared. It is the first of importance 
emanating from Guy's Hospital, and the only two-volume work on the Practice of 
Medicine that has been issued for a number of years. Several subjects, such as 
Syphilis, that are usually omitted or but slightly spoken of in a general work of this 
character, receive full attention. 

Dr. Walter Moxon, one of Dr. Fagge's contemporaries, and a great personal 
friend, writes of him, in a recent number of the London Lancet : — 

" Fagge was, to my mind, the type of true medical greatness. I believe he was capable of any kind of 
excellence. His greatness as a physician became evident to observers of character very soon after his brilliant 
student career had placed him on the staff of Guy's Hospital; he did not merely group already known facts, 
but he found new facts. Former volumes of Guy's Hospital Reports contain ample and most valuable proof of 
his greatness as a physician. His power of observation was sustained by immense memory, and brought into 
action by vivid and constant suggestiveness of intelligence. He was a physician by grace of nature, and being 
gifted with a quickness of perception, a genius for clinical facts and a patience in observation, he was at once 
recognized as a successful practitioner and a leading figure in the hospital and among the profession. 



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